Direct answer: Possibly. The Marketplace runs two separate affordability tests.
- The employee test uses what the employee would pay for the cheapest self-only plan.
- The family test uses what the employee would pay for the cheapest plan that covers the employee and the family members offered coverage.
For 2027 plan years, an employer offer is affordable if the employee's share is no more than 10.22% of household income (9.96% in 2026). If the family premium is above that line, or the plan does not provide minimum value, your spouse and children may qualify for premium tax credits even though you do not. They still have to meet the other eligibility rules.
The two tests side by side
| Employee test | Family member test | |
|---|---|---|
| Premium used | Employee's share for the lowest-cost self-only plan that provides minimum value | Employee's share for the lowest-cost minimum-value plan covering the employee and all offered family members |
| Affordable if, for 2027 plan years | That amount is 10.22% of household income or less | That amount is 10.22% of household income or less |
| If affordable | The employee cannot get a premium tax credit | Family members cannot get a premium tax credit |
| If not affordable, or no minimum value | The employee may qualify | Family members may qualify |
"Minimum value" means the employer plan is designed to pay at least 60% of total allowed costs and covers substantial hospital and doctor services. The employer can tell you whether the plan meets it.
Worked example (illustrative figures, not a quote)
Household income for the coverage year is $70,000. The 2027 affordability line is 10.22% of $70,000 = $7,154 a year, or about $596 a month.
| Employer offer | Employee's monthly share | Yearly | Share of income | Result |
|---|---|---|---|---|
| Self-only | $120 | $1,440 | 2.1% | Affordable: the employee stays on the job plan or buys at full price |
| Employee + spouse + children | $850 | $10,200 | 14.6% | Not affordable: the spouse and children may qualify for Marketplace credits |
The test uses the premium for the employee plus the family, not a family-only premium. It uses the lowest-cost plan offered, even if you enrolled in a richer one.
Plan-year timing
Affordability is tied to the employer's plan year. If the employer's plan year does not start January 1, the percentage for the year the plan year starts applies. Ask HR for the plan-year start date and next year's premiums. You can use the CMS Employer Coverage Tool to gather the information the Marketplace asks for.
Florida details that matter
- Adult Medicaid: Florida has not expanded Medicaid to most adults under the ACA, so a spouse with low income usually has no adult Medicaid option.
- Children: Children may qualify for Florida Medicaid or Florida KidCare. The HealthCare.gov application screens for both.
- Household income: For 2027 coverage, premium tax credits require household income from 100% to 400% of the federal poverty line. That is $33,000 to $132,000 for a family of four, using the 2026 poverty guidelines that apply to 2027 coverage.
How to apply
- Get the employee-only and family premiums for the lowest-cost minimum-value plan, and the plan-year start date.
- Estimate household income for the coverage year.
- On HealthCare.gov, answer the job-coverage questions for each family member who was offered coverage.
- Apply for the family members only. The employee can stay on the job plan.
Taking family members off the job plan mid-year depends on the employer's rules. Marketplace enrollment needs Open Enrollment (November 1, 2026 to January 15, 2027 for 2027 coverage) or a qualifying event.
Bring the employer's premium sheet and your income estimate. Call (863) 640-3102
Related reading
- How much income qualifies for a subsidy in Florida?
- What counts as income for Marketplace plans
- Lakeland ACA help
- Employee losing group coverage
- ACA subsidy estimator
Common questions
Can my spouse or children get Marketplace coverage if my employer offers insurance?
Possibly. The Marketplace tests the family premium separately from the employee-only premium. If covering the employee and offered family members costs more than 10.22% of household income for 2027 plan years, or the plan lacks minimum value, family members may qualify for premium tax credits if they meet the other rules.
Is employer affordability calculated the same way for the employee and the family?
No. The employee test uses the employee's cost for the lowest-cost self-only plan. The family test uses the employee's cost for the lowest-cost plan that covers the employee and all offered family members.
What is the employer affordability percentage for 2027?
10.22% of household income for plan years beginning in 2027, set by IRS Revenue Procedure 2026-26. For 2026 it is 9.96%.
Does an unaffordable family premium automatically qualify my dependents for savings?
No. Affordability is one test. The Marketplace also checks household income, tax household, other coverage, residence and enrollment timing.
Sources
- IRS, Rev. Proc. 2026-26 (2027 applicable percentage table; required contribution percentage 10.22%)
- IRS, Rev. Proc. 2025-25 (2026 required contribution percentage 9.96%)
- IRS, Final regulations on family-member affordability (T.D. 9968), IRB 2022-45
- HealthCare.gov, Affordable coverage (glossary)
- CMS, Employer Coverage Tool
- HHS/ASPE, 2026 poverty guidelines (family of four $33,000)
- KFF, Status of state Medicaid expansion decisions
- HealthCare.gov, Dates and deadlines