Is this decision grid free?

Yes. The grid unlocks immediately after you enter your contact details. Unlocking it means a licensed insurance agent may follow up — that is what the consent covers. There is no cost, and no purchase is required.

What is the family-glitch fix, exactly?

Before the 2023 plan year, an employer offer counted as affordable for a worker's whole family if the employee's own self-only coverage was affordable, even when adding the family was expensive — the so-called family glitch. Under IRS regulations effective for 2023, a family member's affordability is now judged on the cost to cover the family, not the employee's self-only premium. The practical effect: a worker can have affordable self-only coverage while a spouse and children still qualify for marketplace savings.

How do I know if my employer offer is "affordable"?

Affordability is decided by the marketplace application's own test, which compares the required premium to a percentage of household income that is set each year. Rather than guess, answer the application's employer-coverage questions exactly as written — the marketplace runs the test for you. The grid explains what the answer means for your subsidy, but it does not replace the application's determination.

Free guide · plan year 2026

Employer vs. marketplace decision grid

Updated for plan year 2026

When you are weighing a job-based plan against a marketplace plan — starting a job, leaving one, or sizing up an offer — the honest comparison runs across a few fixed factors. This grid lays them side by side: who pays the premium, when a marketplace subsidy is even available, the COBRA bridge after a job ends, and network continuity. It flags the one affordability rule that quietly decides eligibility for many households, and marks when each side genuinely wins.

What’s inside

A side-by-side grid on the factors that decide it: who pays the premium, subsidy eligibility, the bridge after a job ends, and network continuity
The affordability rule in plain terms — how an employer offer the rules count as affordable can switch off marketplace subsidies, even if no one enrolled
The family-glitch fix: how, since 2023, a family member's affordability is judged on the cost to cover the family, not the employee's self-only premium
The COBRA bridge — continuing the same plan at up to 102% of the full premium, and how it compares with a subsidized marketplace plan
When each side wins, and the 60-day special enrollment window after a job ends, including the coverage-start mechanics that can leave a short gap

Who it’s for: For anyone deciding between a job-based plan and a marketplace plan — leaving a job, starting one, or weighing whether to add family members to an employer offer.

How it works

The employer-versus-marketplace decision runs across a handful of fixed factors, and one rule sits underneath all of them.

On cost, an employer plan splits the premium: the employer covers part, you pay the rest, usually pre-tax. The published "premium" is only your share. A marketplace plan charges the full premium, but a premium tax credit can lower it — the credit is the gap between a benchmark silver plan and a set share of your income, so lower incomes pay less.

The rule that decides eligibility is affordability. If someone in your household is offered employer coverage the rules count as affordable, that generally ends marketplace subsidy eligibility for the people the offer can cover — even if no one enrolled. The marketplace application asks about employer offers for exactly this reason.

The family-coverage test changed this in an important way. Before 2023, an offer counted as affordable for a whole family if the employee's self-only coverage was affordable — the family glitch. Under IRS rules effective for the 2023 plan year, a family member's affordability is now judged on the cost to cover the family. So a worker can have affordable self-only coverage while a spouse and children, facing a high family-coverage cost, may still qualify for marketplace savings.

After a job ends, COBRA can continue the exact same plan, but at up to 102% of the full premium — your old share plus the employer's, plus an administrative charge. Losing job-based coverage also opens a 60-day special enrollment window, usable up to 60 days before a known end date. The employer plan usually wins when the contribution is real and the offer is affordable; the marketplace usually wins when there is no affordable offer or income makes the subsidy large.

All figures you compute using this decision grid are estimates for comparison, not quotes. Actual premiums, subsidies, and eligibility are determined at enrollment. The Insurance Guide is independent — not HealthCare.gov, a state marketplace, an insurer, or a government agency.

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Frequently asked questions

Is this decision grid free?: Yes. The grid unlocks immediately after you enter your contact details. Unlocking it means a licensed insurance agent may follow up — that is what the consent covers. There is no cost, and no purchase is required.
What is the family-glitch fix, exactly?: Before the 2023 plan year, an employer offer counted as affordable for a worker's whole family if the employee's own self-only coverage was affordable, even when adding the family was expensive — the so-called family glitch. Under IRS regulations effective for 2023, a family member's affordability is now judged on the cost to cover the family, not the employee's self-only premium. The practical effect: a worker can have affordable self-only coverage while a spouse and children still qualify for marketplace savings.
How do I know if my employer offer is "affordable"?: Affordability is decided by the marketplace application's own test, which compares the required premium to a percentage of household income that is set each year. Rather than guess, answer the application's employer-coverage questions exactly as written — the marketplace runs the test for you. The grid explains what the answer means for your subsidy, but it does not replace the application's determination.