Employer-Sponsored Health Coverage

The Basics

Health coverage helps pay for medical costs. A health care plan has a set of services that the plan provider agrees to pay for if you need them, like when you see a doctor or go to the pharmacy.

One way to get health coverage is through government programs, like Medicare, Medical Assistance (MA), or MinnesotaCare. Another way is to get private health coverage by buying an individual plan on your own or by getting coverage through your job, your parent’s job, or your spouse’s job, which is called employer-sponsored group health coverage. Getting coverage through your job or through a family member’s job is the most common way people get health coverage in the United States.

This article is about getting health coverage through an employer. It will help you understand:

  • If employer-sponsored coverage is right for you
  • What services your plan will cover
  • How to choose a plan
  • How much you will have to pay for health care, and
  • How to sign up.

If you need more help in understanding employer-sponsored coverage after reading this article, we recommend you talk to trained experts. Here are some good resources:

  • An employer’s Human Resources department will know about the specifics of the health coverage options it offers.
  • The Minnesota state government has an informative website about changes to health care.
  • If you have questions about how your disability affects your health coverage, Chat with a Hub expert.
  • All employer-sponsored plans should meet minimum affordability standards. That means that the employed individual should be able to pay 9.12% or less of her household income for the plan’s monthly premium for her own coverage.
  • All employer-sponsored plans should meet a certain benefits level. That means the plan benefits should be equal to or better than the benefits offered by bronze-level plans available on MNsure.
  • If your income is at or under 138% of the Federal Poverty Guidelines (FPG), you can get MA coverage, even if you also have employer-sponsored coverage. Your MA coverage may pay your portion of your premium through your job-based insurance.

Note: DB101 keeps track of changes to health coverage and related laws. DB101 has been and will continue to be updated to reflect any changes. For news related to health coverage, visit the Minnesota Department of Human Services (DHS).

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