Does my employer have to give me health insurance?

This page is general information, not legal advice. For your exact situation, talk with a free legal clinic or the agencies listed here.

Does my employer have to give me health insurance?

It depends on the size of the company and your hours.

• Fewer than 50 full time workers: No federal law makes the employer offer health insurance. Some small employers still do, so ask.
• 50 or more full time workers (including full time equivalents): The employer is an "applicable large employer" under the Affordable Care Act (ACA). It must offer health coverage to at least 95% of its full time employees and their children up to age 26, or it may owe a fee to the IRS.

The size is counted for the whole company, based on the year before. Part time hours are added up into "full time equivalents."

Even a large employer is not ordered to offer a plan. The IRS says it can choose to offer coverage, or it may owe a payment instead (IRS). Legal Aid at Work, a nonprofit, says that outside this ACA rule, employers are not required to provide health benefits. Some local rules are different. San Francisco's Health Care Security Ordinance says employers with 20 or more workers must spend a minimum amount on health care for workers in the city (sf.gov). Some city and county contractor rules differ too (see below). An employment attorney can tell you whether one covers your job.

Who counts as full time?

Under the ACA, you are full time for a month if you average at least 30 hours a week, or 130 hours a month.

If you work fewer hours, a large employer does not have to offer you coverage under this rule. It still may choose to.

What must a large employer's plan look like?

To avoid the fee, a large employer's offer has to meet three tests:

1. Real coverage. The plan must count as "minimum essential coverage."
2. Minimum value. The plan must pay for a basic share of costs.
3. Affordable. For plans that start in 2026, your share of the monthly cost for self only coverage can't be more than 9.96% of your household income.

The employer must also offer it to your children under 26. The ACA rule does not require coverage for a spouse.

What happens if a large employer doesn't offer it?

The employer may owe the IRS an "employer shared responsibility payment." That fee is triggered when at least one full time worker buys a plan through the Marketplace (Covered California in our state) and gets a premium tax credit.

The fee goes to the government, not to you. This rule does not give you a way to make your employer add you to a plan. What it does give you is a way to get help paying for your own coverage, if you are eligible for Covered California.

How long can they make me wait?

If you are eligible for your employer's plan, the plan can't make you wait more than 90 days to start coverage.

What if my employer doesn't have to offer it?

You still have options. Which one fits depends on your income and your immigration status.

• Covered California. For people who are lawfully present. If your job offers no affordable coverage, you may qualify for financial help.
• Medi-Cal. Free or low cost coverage for people with low income. Many working people qualify. See Medi-Cal for adults in 2026.
• County programs and clinics. See What if I can't get Medi-Cal or Covered California?

What are my options by immigration status?

Covered California's own rules, checked October 19, 2026:

Important details:

• Already on full Medi-Cal? If you had full Medi-Cal as an undocumented adult, you can keep it if you stay eligible and renew on time. If your coverage ends, you have three months to sign back up. After that, only restricted Medi-Cal (emergencies, pregnancy and nursing home care) is open to you.
• Premium coming. Starting July 1, 2027, many adults ages 19 to 59 on full Medi-Cal whom the state lists with "unsatisfactory immigration status" (including undocumented adults, adults with DACA and green card holders in the five year wait) will pay a monthly premium. The amount is not set yet. State law says it will be $30 to $50 a month per person, and the governor will set the exact amount in May 2027. The state budget plan expects $50 (DHCS budget highlights; LAO, checked October 23, 2026). Some county pages show $30, the amount set in 2025. More: Medi-Cal changes in 2027.
• Emergency Medi-Cal is still there for serious medical emergencies, whatever your status.
• Mixed status families: you can apply for your children through Covered California even if you can't enroll yourself. List everyone in the household. Each person's eligibility is decided separately.

Covered California says applying will not affect your immigration status or your chances of getting a green card or citizenship. Public charge rules changed in September 2026, so if you are applying for a green card, check What benefits can I use? and talk with a free legal clinic.

What if I can't get Medi-Cal or Covered California?

• San Mateo County ACE program. Health coverage for low income adults 19 and older who don't qualify for other programs. There is a $360 application fee and a $360 yearly fee, which you can pay as $30 a month. Call the Health Coverage Unit at 650-616-2002, or ask a Community Health Advocate at a San Mateo Medical Center clinic or at Ravenswood Family Health Network. San Mateo County says legal status is not required for county funded coverage.
• Community health centers. Federally funded health centers, like Ravenswood Family Health Network in East Palo Alto (650-330-7400), may not turn anyone away because they can't pay. They use a sliding fee based on income.
• 211 can help you find low cost clinics in Santa Clara County and anywhere in the Bay Area. See 211.

Can my employer pay me more instead of giving insurance?

Some do, but no federal rule requires it. Some cities and counties have living wage rules for workers at companies that hold their service contracts. For example, San Mateo County's living wage rule covers workers on county service contracts signed on or after April 1, 2017, and sets $20.90 an hour from July 1, 2026. The county's page does not mention health benefits (San Mateo County living wage). Other cities have their own rules, and some may include health benefits. Ask your city, your union or a free legal clinic.

What should I ask my employer?

Put it in writing (email or text) so you have a record:

1. How many full time and part time workers does the company have?
2. Am I eligible for the health plan? If not, why not?
3. When can I enroll, and how long is the waiting period?
4. How much will I pay each month for coverage for just me?
5. Can I add my children?

If the answer is "you don't qualify," ask for the plan's eligibility rules in writing.

What mistakes should I avoid?

• Don't assume part time means no options. You may still qualify for Medi-Cal, Covered California, ACE or a clinic sliding fee.
• Don't miss renewal letters. If you have Medi-Cal, answer every renewal notice on time. For undocumented adults, losing Medi-Cal now can mean you can't get full coverage back.
• Don't buy "health plans" from door to door sellers or social media ads without checking them. Use Covered California, the county or a clinic.
• Don't pay someone to fill out a Medi-Cal or Covered California application. Free help is available from the county and certified enrollers.

Common questions

My job has 60 workers but only offers insurance to managers. Is that legal? A large employer must offer coverage to at least 95% of its full time workers or risk the IRS fee. Whether leaving out some full time workers breaks other laws depends on the facts. Ask a free legal clinic.

I work 25 hours a week at two jobs. Does either one have to cover me? Each employer looks at your hours with them. At 25 hours a week, neither has to offer coverage under the ACA rule.

My employer offers a plan, but it costs too much. Can I get help from Covered California? If the offer is affordable and meets minimum value, you generally can't get Covered California financial help. If it costs more than 9.96% of your household income for self only coverage in 2026, you may qualify. Covered California can check.

Does my employer need my immigration status to put me on the plan? We did not find an official rule that answers this. Ask HR for the plan's written eligibility rules and what papers it needs, and talk with a free legal clinic before you share documents you are not sure about.

I got sick and missed work. Is there help? Yes. See Paid sick days in California and State Disability Insurance.

Who can help?

Contact them to confirm hours, languages and openings. Being listed here is not a referral or a promise of service.

• San Mateo County Health Coverage Unit: 650-616-2002 (ACE and other coverage)
• Ravenswood Family Health Network: (650) 330-7400
• Covered California: coveredca.com
• 211 Bay Area: dial 211
• Legal Aid at Work and other free clinics: see Free legal help in the Bay Area
• Community Legal Services in East Palo Alto: (650) 326-6440

Health care is not a luxury. You and your family deserve care, and there is a door open for almost everyone. Start with one call.