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One spouse offered insurance, the other does not...

Hello good people of OCF!

I have scoured the internet have not been able to find an answer to my question.  So, here we go...

Spouse #1 is being offered, according to the rules, affordable insurance for him/herself (individual premium falls below 9.5%).
Spouse #2 declined health insurance on hire date and therefore is no longer qualified to receive insurance.
They are married, and have one child living in California.

Spouse #1 is not eligible for premium assistance through Covered California (CC) because that person has access to "affordable" insurance premium.  Since spouse #2 is not offered insurance through the employer, does spouse #2 and child qualify for CC?

Spouse #1 is offered a family premium plan.  Does that make spouse #2 and child ineligible for CC?

My hope is that Spouse #1 can obtain self insurance through the employer, while spouse #2 and child can benefit from lower premium via CC.  In total, if this was to work, it would result in a savings in the range of $434.40-$481.92.

Looking forward to hearing some solid advice.

Thanks in advance!

Thanked by 1Bob_Moderator


  • Can I ask if the spouse without insurance has applied to private insurance or not?
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