In addition to the different types of assistance provided by the government within the insurance affordability programs, another way in which the ACA attempts to make health care more affordable to citizens is by ensuring employers provide contributions towards health care for their employees. Since large employers typically already have agreements in place with insurance carriers, the focus in terms of providing this employer-sponsored insurance (ESI) has been on small employers, hence the requirement for states to provide a small employer exchange as well as the individual exchange described above. Both exchanges operate in much the same way, with the only real difference being the range of plans available to employees, and the assistance they can avail of in paying for premiums associated with those plans.
Employers enter summary details of the employees on the exchange in the form of a roster of qualified employees, and choose a contribution to make towards their coverage as well as the plan(s) made available to them for selection. Employees can then select the plan(s) offered to satisfy the individual mandate for minimum essential coverage through employer-sponsored insurance.
The law provides tests to ensure compliance - an affordability check verifies that employers are fulfilling their obligation to provide affordable health care to their employees and that employees aren't having to pay excessive premiums as a result. If the employer-sponsored coverage is considered affordable, after considering the financial situation of the employee, then the employee can avail of this ESI. If not affordable, then the employee is entitled to waive their ESI and apply for assistance in purchasing insurance through the individual exchange instead; the employer in this circumstance is subject to a penalty as they have not provided affordable coverage.