New Health Insurance Marketplace Coverage Options and Your 

Health Coverage 

 

1 

An employer-sponsored health plan meets the "minimum value standard" if the plan's share of the total allowed benefit costs 

covered by the plan is no less than 60 percent of such costs.

General Information

When key parts of the health care law take effect in 2014, there will be a new way to buy health insurance: the 

Health Insurance Marketplace. To assist you as you evaluate options for you and your family, this notice provides 

some basic information about the new Marketplace and employment based health coverage offered by your 

employer. 

What is the Health Insurance Marketplace? 

The Marketplace is designed to help you find health insurance that meets your needs and fits your budget. The 

Marketplace offers "one-stop shopping" to find and compare private health insurance options. You may also be 

eligible for a new kind of tax credit that lowers your monthly premium right away. Open enrollment for health 

insurance coverage through the Marketplace begins in October 2013 for coverage starting as early as January 1, 

2014. 

Can I Save Money on my Health Insurance Premiums in the Marketplace? 

You may qualify to save money and lower your monthly premium, but only if your employer does not offer 

coverage, or offers coverage that doesn't meet certain standards. The savings on your premium that you're eligible 

for depends on your household income. 

Does Employer Health Coverage Affect Eligibility for Premium Savings through the Marketplace? 

Yes. If you have an offer of health coverage from your employer that meets certain standards, you will not be 

eligible for a tax credit through the Marketplace and may wish to enroll in your employer's health plan. However, 

you may be eligible for a tax credit that lowers your monthly premium or a reduction in certain cost-sharing if your 

employer does not offer coverage to you at all or does not offer coverage that meets certain standards. If the cost 

of a plan from your employer that would cover you (and not any other members of your family) is more than 9.5% 

of your household income for the year, or if the coverage your employer provides does not meet the "minimum 

value" standard set by the Affordable Care Act, you may be eligible for a tax credit.1 

Even if your employer intends your coverage to be affordable, you may still be eligible for a premium discount 

through the Marketplace. The Marketplace will use your household income, along with other factors, to determine 

whether you may be eligible for a premium discount. If, for example, your wages vary from week to week (perhaps 

you are an hourly employee or you work on a commission basis), if you are newly employed mid-year, or if you 

have other income losses, you may still qualify for a premium discount. 

Note: If you purchase a health plan through the Marketplace instead of accepting health coverage offered by your 

employer, then you may lose the employer contribution (if any) to the employer-offered coverage. Also, this 

employer contribution -as well as your employee contribution to employer-offered coverage- is often excluded 

from income for Federal and State income tax purposes. Your payments for coverage through the Marketplace are 

made on an after-tax basis 

How Can I Get More Information? 

For more information about your FEHB health insurance coverage offered by your employer, please visit 

www.opm.gov/insure or contact your human resources office. 

The Marketplace can help you evaluate your coverage options, including your eligibility for coverage through the 

Marketplace and its cost. Please visit www.healthcare.gov for more information, including an online application for 

health insurance coverage and contact information for a Health Insurance Marketplace in your area.