What if my employer offers coverage, but I can’t afford it?
If the premium for the least expensive individual plan (not a family plan) offered by your employer is more than 9.78% in 2020, or 9.83% in 2021, of your household income your coverage is considered unaffordable. Use our Affordability Estimator to find out.
My employer does not offer health insurance. Can I get health coverage through Vermont Health Connect?
Yes! If your employer does not offer health coverage you may be able to get health insurance, and financial help paying for it, through Vermont Health Connect. You may have to wait for an enrollment period to sign up. Open Enrollment is the time when Vermonters can apply for qualified health plans (QHP) through Vermont Health Connect. Open Enrollment happens once a year, usually in November, and lasts for about six weeks. If you are applying for coverage outside of Open Enrollment, you may still be able to get covered if you’ve experienced a qualifying event.
Medicaid has year-round enrollments, so if you qualify for Medicaid, you don’t need to wait for Open Enrollment to sign up.
If I voluntarily drop my COBRA coverage after Open Enrollment, will I qualify for a Special Enrollment Period?
No. If you voluntarily drop your COBRA coverage before it expires, you will not qualify for a Special Enrollment Period through Vermont Health Connect. That means you may not be eligible to enroll in a Vermont Health Connect plan until Open Enrollment (typically in November) unless you experience a qualifying event.
COBRA coverage lasts for 18 months, at which time it will expire. When your COBRA coverage expires at the end of 18 months, you may be eligible for a 60 day special enrollment period through Vermont Health Connect and can enroll in coverage.
I am eligible for Medicaid; do I have to take my employer’s insurance coverage?
No, if you are eligible for Medicaid, you do not have to take your employer’s insurance. Alternatively, if you want to have both Medicaid and your employer's coverage, you may.
My employer offers a Health Reimbursement Arrangement (HRA). Can I use this to help pay for a health plan through Vermont Health Connect?
If your HRA is affordable, you must enroll in a full price plan without advance premium tax credits (APTC) and use your HRA to help pay for the cost.
If your HRA is not affordable and you qualify for APTC, you can enroll and use the tax credits to help pay for the monthly cost of a plan, but you must opt out of the HRA.
To figure out if your HRA is affordable, visit our HRA Affordability Worksheet. You may enroll in a plan during Open Enrollment, or you may qualify for a Special Enrollment Period (SEP) if it is a new offer of HRA.