Employer health plan eligibility tested as ACA Marketplace shrinks

There’s usually more flexibility in plan design than a straight yes or no. Waiting periods, hours thresholds, contribution tiers by pay band and a cheaper plan option for lower-paid staff can all change the math, and many employers are already rethinking where benefits dollars go ahead of 2027 renewals.

Deductibles are climbing for people who stay on the Marketplace

Employees’ spouses, dependents and part-timers who keep individual coverage are taking on more risk. Bronze plans made up 40 percent of 2026 Marketplace selections, compared with 30 percent the year before, and the average deductible rose 37 percent to a record $3,786, according to KFF’s analysis of 2026 Marketplace coverage published this year.

Accident, critical illness and hospital indemnity coverage can help with a large deductible where employers offer it outside full medical eligibility. Piling on products has its own problems, though. Nicole Negvesky, executive vice president of employee benefits at Alera Group in Chicago, has warned that stacking supplemental coverage without education leaves employees with menus they don’t understand and don’t use.

“Historically, we’ve seen very low utilization of supplemental plans,” Negvesky said in an interview earlier this month.

Fewer brokers on the Marketplace

CMS has also barred new agents and brokers from the federally facilitated Marketplace until February 1, 2027. Employers that refer ineligible workers to outside enrollment help may find fewer new brokers taking clients during the 2027 open enrollment period.