Affordable Care Act – Frequently Asked Questions

  1. Can I opt out of SAG–PHP coverage in favor of coverage through the Marketplace?

    You can always purchase coverage through the Marketplace. However, if you are eligible for SAG-PHP Earned or Senior Performers coverage you are not eligible for a premium subsidy through the Marketplace.

  2. How does the federal health insurance subsidy work?

    When you apply for coverage through the Health Insurance Marketplace, you will estimate your 2016 household income. If your estimated income is less than four times the Federal Poverty Level for the size of your household, you may receive a subsidy from the Federal government to offset the cost of your coverage.

    The government will pay the subsidy directly to your insurer every month.

    If you are eligible for Earned or Senior Performer coverage under the SAG-PHP you are not eligible for the federal subsidy.

  3. Do the premiums I pay for my SAG – PHP health coverage qualify for the subsidy?

    No. The subsidy (also known as the health insurance premium tax credit) is only available through health plans purchased on the Marketplace.