I have health insurance through my employer. What do I need to know?

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Open enrollment for the Marketplace is in full swing, which means it’s time to evaluate health insurance options for you and your family. Whether you are already covered through your employer or are shopping on the Marketplace, it’s important to understand all of the options available.

If you have health insurance through your employer you are most likely considered covered under the health care law and shouldn’t face a tax penalty come tax time. However, it’s still a good idea to check out your plan and make sure you want to keep the same coverage from last year or if you want to make changes during your company’s open enrollment period. Anything from adding another child to your plan to adding a spouse are important changes you need to make during open enrollment unless you have a qualifying life event that allows you to make changes to your coverage during the year.

So what kind of questions should you be asking? We’ve compiled a list of some of the most important questions to help you get educated:

Are you in compliance with the Affordable Care Act (ACA)?

Your employer and/or Human Resources department are responsible for making sure that the health coverage they provide is ACA compliant. To avoid a tax penalty however, you should read through your company’s policy to make sure it covers all your family members in your household and there are no surprises.

 If you have health insurance through your employer does that also cover your family?

Not necessarily. Some companies may not offer spousal or dependent coverage. And, typically, if you can add them, you would need to pay for their monthly premiums.  This is important to be aware of because any individual in a household not covered would incur a tax penalty during tax time. If your company does not allow you to enroll dependents on your plan, you can consider going through healthcare.gov or your state Marketplace to explore options. To determine if family members are eligible for subsidies (based on total annual household income) that can help pay for monthly premiums, try the TurboTax income estimator.

If you want to keep your current plan that you have for next year too, can you do that?

Usually, if you don’t make changes you’ll be automatically enrolled in a plan that is the same or similar to the plan you had last year.  However, it’s a good idea to check in with your employer/HR department as there may be some changes to the plans they offer including premiums, deductibles, co-pays and network. Employers may also change plans all together because they were unable to negotiate the same plan they did last year.

 How can you evaluate if Marketplace might be a more affordable option?

If you have job-based coverage, but choose to enroll in a Marketplace plan instead, you most likely won’t qualify for a premium tax credit and other savings — even if your income would qualify you otherwise. To determine if the Marketplace is still a more affordable option for you, you can use healthcare.gov plans & prices tools.

How will you prove you have health insurance?

If you have employer-based coverage, you may receive new form(s) this year – the 1095-B and C. You do not need to wait for the form(s) to file your taxes. Per the IRS, the forms do not need to be filed with your taxes and are for informational purposes only. Simply check them for accuracy and keep them for your records.

TurboTax is always up to date with the latest tax laws.  If you have more questions about how the Affordable Care Act impacts you and your taxes you can go to TurboTax Health.


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