Can individuals with employer-sponsored insurance purchase additional coverage through the Marketplace?

Individuals with employer-sponsored insurance can purchase additional coverage through the Marketplace if their employer's plan does not meet certain criteria, specifically minimum value or affordability standards.

Minimum value means that the plan must cover at least 60% of the total allowed costs of medical services for a standard population. Affordability relates to the employee's share of premium costs, which should not exceed a certain percentage of their household income. If an employer's plan fails to meet these standards, individuals may qualify for premium tax credits and cost-sharing reductions when purchasing a plan through the Marketplace. This option allows people to secure additional health coverage that could be more suitable for their needs.

In this context, the other choices are not aligned with the regulations governing the Marketplace and employer-sponsored insurance. The first choice incorrectly states that individuals are entirely ineligible to buy additional coverage. The second option suggests a condition regarding premium discounts, which is not a requirement for accessing Marketplace options. The last choice mentions an annual enrollment period, which does not apply since individuals can apply for Marketplace coverage outside of this period if they meet specific eligibility criteria, particularly related to their employer's plan.