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Application Spotlight: Employer-Sponsored Coverage (ESC 2026

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The document is an Employer Coverage Tool worksheet designed to assist individuals in gathering necessary information about employers that provide traditional health coverage for their Marketplace application. It outlines the required employee and employer details, eligibility for health coverage, and costs associated with the lowest-cost plans. The tool is not to be used for businesses offering Health Reimbursement Arrangements (HRAs) and provides resources for additional assistance.

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How to use or fill out Application Spotlight: Employer-Sponsored Coverage (ESC)

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Click ‘Get Form’ to open it in the editor.
Begin with the Employee Information section. Fill in the employee's full name and Social Security Number (SSN).
List all household members who may be eligible for health coverage through the employer, indicating their eligibility status.
In the Employer Information section, provide details such as the employer's name, contact person, address, phone number, email address, and Employer Identification Number (EIN).
Answer questions regarding the health coverage offered by the employer. Confirm if plans meet minimum value standards and specify costs for individual and family plans.

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Versions	Form popularity	Fillable & printable
2022	4.4 Satisfied (59 Votes)
2014	4.3 Satisfied (41 Votes)

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