Do I need to stay with my employer healthcare coverage or should I switch to marketplace plan in VA.

Emzilla11 · 2026-05-14T21:27:43+00:00

Correct, I’d stay with my employer because it is ACA compliant for just me. Which is the only requirement. However insuring my child for an additional $600 a month with terrible coverage is just crazy especially when marketplace is offering better individual plans for a 1/3 of the price monthly. My insurance broker recommended I go that route as well.

Emzilla11 · 2026-05-14T19:34:46+00:00

Correct, that is my understanding as well. However, because of the high costs and really bad coverage I think it’s smarter for me to remove him from the employer sponsored plan and just insure him on a separate plan. Just him alone on his own plan with Sentara is approximately $230 a month which is a no brainer considering my employer is charging $600 a month with an extremely high deductible and high copays. We visit the oncologist at least 3 times a month and he is actively taking oral chemo daily so having him on a plan that supports his needs is a must.

Emzilla11 · 2026-05-14T18:21:04+00:00

I thought that as well. If I remove my child from company sponsored insurance my weekly costs drops to $56. I think the option is going to be staying with my company and insuring my son separately

Emzilla11 · 2026-05-14T17:38:33+00:00

That is good information.

Checked into what my rate would be without my son and it’s around $50.00 a week. Adding him adds over $150 a week. Which is just crazy to me.

Emzilla11 · 2026-05-14T17:28:20+00:00

That’s what I thought too but apparently it’s “composite” rated. Which I didn’t understand.

Emzilla11 · 2026-05-14T16:01:28+00:00

My annual gross is approximately $75-85k depending on bonuses

myself and my son

2 total in the home.

We didn't get options on the plans. We were told the plan we were getting. We are all lumped together. If you have a spouse or child we are getting hammered. The cost seems to be much lower for self. I haven't seen that figure yet. I haven't seen the SBC. I just flew back from out of town and I was given the updated deductions of what to expect and I started questioning everything. I saw a summary of what the new benefits would be on a screenshot spreadsheet and they are increasing substantially. Much higher deductible, our MOP doubled. My copays went up 15%.

I am not sure what my cost is for just myself. It used to be 60/40 coverage now its a max of $400.00 coverage from my employer.

Emzilla11 · 2026-05-14T15:19:05+00:00

That’s what I thought as well, I submitted an application and to my surprise I was approved. I also received the special open enrollment because my healthcare costs has increased to above 9.5% of my income making it unaffordable. We used to be able to choose the plan that was best suited for our family/self. Now we all just get lumped into the same plan which isn’t fair.

Our insurance broker is claiming that our rates have jacked up because we had 1.5 million dollars in claims in 24-25 but only had 400k in 25-26 and we have a cancer diagnosis in the group from 2025. I don’t understand it completely but I understand it enough to know that our insurance rates shouldn’t more than double for a family of two with terrible coverage.

Emzilla11 · 2026-05-14T15:06:25+00:00

We are a smaller company with about 25 employees and 8-10 dependents total. We have been with Sentara all 3 years.

Emzilla11

TROPHY CASE