A Checklist for Employer-Sponsored Health Insurance

Find out whether you, your spouse or partner, and your children can receive health insurance coverage from your employer by considering the following.

• Your employer's size: As of January 1, 2016, employers with 50 or more full-time employees are required to offer health insurance to full-time employees. Smaller employers are not required to offer coverage.
• Your marital status: Employers are not required to extend health benefits to employees’ unmarried partners. Check with your employer’s human resources department to find out whether benefits cover your partner. If opposite-sex spouses are covered by your employer’s insurance, these benefits extend to same-sex partners.
• Whether you have children: Under the Affordable Care Act, employers that are required to offer health insurance coverage to full-time employees also are required to offer it to their employees' dependent children, up to age 26.
• Your tax bracket: Employer-sponsored health insurance coverage may have tax implications, particularly where spousal benefits are provided. An employee who is unmarried, for instance, must pay taxes on the coverage his or her partner receives from the employer, while an employee who is married does not.
• The cost: Because employers are unlikely to know the household income of their employees, there are three safe harbors that an employer may use to determine the “affordability” of employer-sponsored health insurance coverage under the Affordable Care Act. In general, employers are allowed to use Form W-2 wages, an employee’s rate of pay, or the federal poverty line instead of household income in making the affordability determination.

Learn more about the unique considerations for same-sex couples when it comes to employer-sponsored health insurance coverage.