If your employer offers you health insurance through the SHOP Marketplace, you can decline it. If you do, you have other health insurance options.

FYI We talk about 2 different insurance Marketplaces below:

  • The Small Business Health Options Program (SHOP) Marketplace. It’s the Marketplace your employer uses to offer you SHOP Marketplace coverage.
  • The Health Insurance Marketplace for Individuals & Families. This is where people can buy insurance plans directly from an insurance company.

Option 1. Buy a plan through the Health Insurance Marketplace for Individuals & Families

You can buy insurance through the Health Insurance Marketplace for Individuals & Families instead of accepting your employer’s insurance offer. But there are important facts to consider:

  • You probably won’t qualify for savings. In most cases you’d have to pay full price for a plan through the Health Insurance Marketplace for Individuals & Families. Because you have an insurance offer from an employer, you won’t qualify for a premium tax credit to lower your insurance costs — even if you don’t accept the offer of employer coverage.
  • Your employer won’t contribute to your premium. Most employers offering SHOP Marketplace insurance will pay part of your monthly premium. If you buy a plan in the Marketplace for Individuals & Families instead, your employer won’t pay any of your premium. You’ll have to pay the whole premium yourself.

Visit the Health Insurance Marketplace for Individuals & Families.

Note: It’s against the law for your employer to punish or retaliate against you if you buy a plan through the Health Insurance Marketplace for Individuals & Families instead of accepting their plan. Learn more about your protections and non-retaliation.

Option 2. Buy an insurance plan outside the Marketplace

  • You can buy a health insurance plan directly from an insurance company, through an agent or broker, or from an online seller.

  • If you buy a plan outside the Marketplace you can’t get a premium tax credit or other savings based on your income. Only plans offered through the Health Insurance Marketplace for Individuals & Families qualify for these savings.

Learn about buying a plan outside the Marketplace.

If you don’t have health coverage: You may pay a fee

If you don’t have qualifying health coverage for all or some months of the year, you may have to pay a penalty with your next federal tax return.

For example, if you don’t have coverage in 2016, you'd pay the higher of these two amounts:

  • 2.5% of your yearly household income
  • $695 per person ($347.50 per child under 18)

For 2017, the amounts of the penalties will be even higher. Learn more about the penalty if you don’t have insurance coverage.

Questions?