If you’re wondering what to do when your employer doesn’t provide health coverage, consider the following approaches. Specific examples and questions are included to help you take action.

Your first move should be to engage in an honest and constructive conversation with your employer. Even if your company isn’t legally required to offer benefits (small businesses with fewer than 50 full-time employees often aren’t), there might be opportunities for change.

For Example Let’s Say:

You work for a small family-run business. While they’ve never offered benefits before, you know they value their employees. You decide to approach them with thoughtful questions.

Questions to Ask Your Employer About Offering Health Insurance:

• “Have you considered offering group health insurance to employees? I’d be happy to share how it could benefit the company and our team.”
• “Would it be helpful if I connected you with a broker to explore affordable health insurance plans for small businesses?”
• “Are you aware of tax incentives available for small businesses offering employee health benefits?”
• “Does our company belong to a larger group of businesses that might qualify as an ALE (Applicable Large Employer) under the ACA regulations?”

If your employer is concerned about costs, you could suggest they seek advice from a benefits broker to explore their options. Sharing resources, such as our blog post that explains the hidden costs of not offering insurance, might help your case.

Step 2: Explore Spousal or Parental Coverage

If employer-sponsored insurance isn’t an option, check if you can join a family member’s plan. Coverage through a spouse’s health plan or, for those under age 26, a parent’s plan, may be a viable solution.

For Example Let’s Say:

You’re married, but you declined coverage from your spouse’s employer when it was initially offered. After your employer confirms they won’t be adding benefits, you revisit this option with your spouse.

Questions to Ask Your Spouse (or Parent) About Adding You to Their Health Insurance:

• “Does your employer’s health plan allow you to add me as a dependent? If so, when is the next open enrollment period?”
• “Can we check whether your employer offers any other health benefits, like an HSA or FSA, that might help with medical expenses?”
• “Are there different plan tiers, and how much would adding me increase the premium?”

If timing is an issue, you may need to wait for the next open enrollment period or a qualifying life event to make changes.

Step 3: Consult a Broker for Individual Plans

If neither your employer nor your family offers coverage, it’s time to explore individual health plans. A broker can guide you toward the most affordable and comprehensive plans tailored to your needs.

For Example Let’s Say:

You’re researching health plans online but feel overwhelmed by the options. A broker streamlines the process by comparing plans offered in your area through platforms like CaliforniaChoice.

Questions to Ask a Broker About Health Insurance Coverage:

• “What’s the difference between subsidized and unsubsidized plans? Would I qualify for subsidies through Covered California?”
• “Can you explain how deductible amounts and out-of-pocket maximums work across different plans?”
• “Which plans provide the best combination of affordability and comprehensive coverage in my area?”
• “How can I verify if specific doctors or hospitals are part of a plan’s network?”
• “Am I eligible for any additional programs, such as Medi-Cal or ACA subsidies?”

Brokers are a valuable resource, often free for consumers, and can make navigating the insurance market significantly easier. You can use our broker connect tool to find a California Broker in your area. 

Step 4: Research Government Programs

If cost is a significant barrier, government programs like Medi-Cal or ACA marketplace plans can help. These options provide more affordable pathways to coverage for those who meet eligibility requirements.

For Example Let’s Say:

You recently experienced a reduction in work hours, bringing your income into Medi-Cal eligibility limits. You decide to investigate further.

Questions to Ask When Exploring Government Health Programs:

• “Am I eligible for Medi-Cal based on my income? How do I apply?”
• “How do ACA subsidies work, and how much could I save on a marketplace plan?”
• “Which ACA plans cover the care providers I currently use?”
• “What documents do I need to submit to verify my eligibility for Medi-Cal or a subsidy?”

Visit platforms like Covered California to estimate your premiums and explore what options align with your financial and medical needs.

Why Securing Health Insurance Matters

Health insurance is essential for protecting yourself against unexpected medical costs and maintaining access to the preventive care that supports long-term health. If your job doesn’t offer health insurance, don’t wait to take action.

By speaking with your employer, exploring family-based plans, consulting a broker, or looking into government programs, you can find a solution that meets your needs. Take initiative, ask the right questions, and prioritize finding the health coverage you deserve. Whether it’s through an employer, a family member’s plan, or the individual marketplace, there’s a path forward for every situation.