Is a Group Health Plan Cheaper Than the ACA Marketplace?

The honest answer depends on your subsidy, your age, and how much care you actually use.

Sometimes, and the deciding factor is usually your age and whether you qualify for a marketplace subsidy. Anyone who tells you a group plan always beats the marketplace is selling something.

Why age is the whole ballgame

The ACA marketplace rates you by age. A 62 year old can legally be charged three times what a 21 year old pays for the same plan. Group plans through Benefit Airship do not work that way: the price depends on how many people are on the policy and nothing else. An individual plan is the same price whether you are 26 or 60.

That single difference explains most of the outcomes. If you are young and healthy, the marketplace is often competitive. If you are in your fifties or sixties, flat pricing tends to look very good.

Subsidies change the answer

If your household income puts you in subsidy range, a marketplace plan can end up costing you far less than its sticker price, sometimes almost nothing. Check what you actually qualify for at HealthCare.gov before comparing anything. A subsidised silver plan is hard to beat, and no honest comparison ignores that.

Compare the year, not the month

The cheapest premium is not the cheapest year. A plan at $269 a month with a $5,000 deductible costs more over twelve months than a $679 plan with a $3,000 deductible if you actually need care. Add the premium to your realistic out-of-pocket spending and compare those totals.

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