5. Employer-Sponsored Insurance

Select the household members who have been offered or have access to employer-sponsored insurance (ESI), even if they are not enrolled in it. Access to coverage could be through the person's own job or through another person's job, such as a parent or spouse.

To help answer questions about ESI: 

• Work with your employer to have the information you'll need to answer ESI questions on the MNsure application with financial help. Using the form Appendix A: Health Coverage from Jobs (PDF) will help you gather the information you will need to complete ESI questions on the application.
  Note: A change to a health care rule makes more families eligible for lower-cost health insurance. This change fixed the “family glitch” – a situation where the cost of family coverage was unaffordable for the household, but the Affordable Care Act considered it affordable, keeping the family from accessing tax credits to lower the cost of their insurance. Because of the change, family members of Minnesotans with offers of family ESI may now qualify for an advanced premium tax credit through MNsure if their access to family ESI is considered unaffordable using the cost of family coverage. To find out if your ESI may be considered unaffordable, use the Employer Insurance Affordability Estimator
• Some health reimbursement arrangements (HRAs) offered by employers affect eligibility for tax credits through MNsure. If you are offered an individual coverage HRA (ICHRA) or a qualified small employer HRA (QSERHA), use the HRA worksheets to help determine how the HRA you’re offered affects your eligibility for a tax credit and how to answer the questions about ESI on the MNsure application.

What does "access to" employer-sponsored coverage mean? 

"Access" means coverage is available to the person, even if the person declines the coverage.

• If a person declined or waived an offer of employer-sponsored coverage for the current plan year, the person DOES have access to employer-sponsored coverage. Answer "Yes" to this question. 
• If a person declined or waived an offer of employer-sponsored coverage for a prior plan year and there is no future option to enroll in an employer plan, the person DOES NOT have access to employer-sponsored coverage. Answer "No" to this question.

Fill in the required fields for those household members who do have access to employer-sponsored insurance. The information provided here will be used to determine if the employer-sponsored coverage qualifies as “minimum essential coverage” (MEC), which may influence eligibility determination. 

Read more about MEC and ESI.

"Does this member have health insurance through an employer?"

This question on the application is asking if the member is actually enrolled in an employer-sponsored plan. Select “Yes” if a household member has health insurance through an employer. If the household member is not enrolled in an employer-sponsored plan, select "No."

Whether you select "Yes" or "No," you’ll need to enter information about the employer, including the employer identification number (EIN), address, and employer-sponsored coverage. The EIN should be entered as a 9-digit number without dashes.

"Is the employee employed full-time?"

If a household member is enrolled in employer-sponsored insurance, the application will ask this question.

Answer “Yes” if the member is employed on average at least 30 hours per week. If less than 30 hours per week, then answer “No.” (Whether you are employed full-time does not impact your eligibility for financial help.)

"Does the employer offer a health plan that meets the minimum value standard?" 

The minimum value standard means the health plan will pay at least 60% of the total cost of medical services for a population and includes substantial coverage of physician and inpatient hospital service. Your employer must tell you if your insurance meets this standard.

If the employer's plan meets the minimum value standard and the cost of coverage that is compared to the income you reported is considered "affordable," you won't be eligible for a premium tax credit if you buy a private insurance plan through MNsure.

Read more about the affordability standard for ESI.

"Is your access to this coverage ending in the next two months?"

How should I answer this question about access to ESI if I am applying during the same month I am still covered (job ends today and coverage goes through end of the month)? 

You should answer this based on your current access to ESI and knowledge of whether it is ending. If you enter “Yes,” that your coverage is ending in the next 60 days, the online application will correctly determine eligibility after ESI ends. However, if you are eligible for premium tax credits, you may not be able to select a plan online for the date when ESI ends. To apply for coverage with financial help, you will need to call the MNsure Contact Center.

Additional Information for all Applicants

Enter additional information about your household, such as whether someone is disabled or blind. This helps determine if you qualify for assistance based on things other than income. 

You must answer "Yes" or "No" to each question.