Employer-Sponsored Insurance (ESI)
All large employers are required to offer their full-time employees health care coverage. You are not eligible for financial assistance on Georgia Access if your employer offers affordable coverage.
If the Employer-Sponsored Insurance (ESI) offered by your employer does not meet the affordability threshold set by the Internal Revenue Service (IRS) based on your income and household size, you are eligible to enroll in a plan on Georgia Access with financial assistance.
To identify if your employer’s coverage is considered affordable, you may use the forms below:
- Employer-Sponsored Insurance (ESI) Coverage Tool (English)
- Employer-Sponsored Insurance (ESI) Coverage Tool (Spanish)
Some employers may offer their employees certain Health Reimbursement Arrangements (HRA) to help offset the cost of health insurance. These plans, known as Individual Coverage Health Reimbursement Health Arrangements (ICHRAs) or Qualified Small Employer Health Reimbursement Arrangements (QSEHRAs), generally involve the employer contributing to the cost of health insurance on behalf of their employees, without offering group health insurance.
Individual Coverage Health Reimbursement Health Arrangements (ICHRAs)
Your employer may offer you an ICHRA instead of traditional ESI. An ICHRA is a health savings account in which you can take funds from your employer to buy health insurance on Georgia Access. Remaining funds can be used to pay qualified medical expenses. If you have an ICHRA, you are not eligible to receive Premium Tax Credits (PTCs) unless the ICHRA is not affordable based on the thresholds set by the IRS.
Individuals who are offered an ICHRA should determine whether the ICHRA meets the federal affordability standard. To find out if your employer’s ICHRA is considered affordable, use the worksheets below.
You can enroll in health care coverage using funds from an ICHRA at Open Enrollment. If your employer newly offers you an ICHRA in the middle of the year, you can enroll in health care coverage with a Special Enrollment Period (SEP).
Qualified Small Employer Health Reimbursement Arrangements (QSEHRAs)
Your employer may offer you a QSEHRA instead of traditional ESI. A QSEHRA is a health savings account provided by small businesses (under 50 full-time employees) used to purchased health insurance on Georgia Access. Remaining funds can be used to pay qualified medical expenses. If you have a QSEHRA, you may also be eligible to receive PTCs depending upon your employer’s contributions. You can enroll in health care coverage using funds from a QSEHRA at Open Enrollment. If your employer newly offers you a QSEHRA in the middle of the year, you can enroll in health care coverage with an SEP.
Individuals who are offered a QSEHRA should determine whether the QSEHRA meets the federal affordability standard. To find out if your employer’s QSEHRA is considered affordable, use the worksheets below.