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Covered CA

An employee wants a different metal tier than is available to him through his employer’s Covered California for Small Business plan. Can he opt out and buy an individual Covered California plan?

Yes, the employee can decline his employer’s coverage and purchase a Covered California individual plan. Agents should bear in mind:

  • the employee will not be eligible for subsidies if he is eligible for his employer’s plan and it is of minimum value and is affordable
  • employees that decline coverage to go to the individual exchange count against the employer’s participation requirement for Covered California for Small Business coverage.