When applying for health coverage with financial help, you'll need to report information about any employer-sponsored insurance (ESI) available to you, even if you are not enrolled in it. Access to ESI can affect your eligibility for financial help.
ESI is coverage under a group health plan (including self-insured plans), such as:
Union and student health coverage are not considered ESI, but may be considered minimum essential coverage (MEC).
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 nearly all the information you will need to complete ESI questions on the application.
You should always accurately report access to ESI, even if you may be eligible for Medical Assistance.
Consumers who have access to ESI or other MEC may not be eligible for financial help.
For MinnesotaCare and advanced premium tax credit (APTC) eligibility:
For Medical Assistance :
What are the affordability and minimum value standards?
A person who is eligible for coverage under an employer-sponsored plan because they are a dependent or spouse of an employee, is considered to have access to MEC if enrolled in or eligible to enroll in the plan.
Does the annual premium for ESI for family coverage have to meet the same affordability standard as employee-only coverage?
No. If the cost of employee-only coverage meets the affordability test then all household members who are eligible to enroll in the ESI plan are considered to have access to MEC, regardless of the cost of family coverage. This means those household members would not be eligible for MinnesotaCare or for tax credits if they enroll in a private plan through MNsure.
An individual that does not have MEC through ESI can be eligible for MinnesotaCare or APTC if: