Oregon employers can help their employees understand their health coverage options, compare plans, and learn about available savings.
Whether you run a small business, work part time, are self-employed, or are looking for coverage for your family, there may be options available to fit your needs and budget.
Health coverage options in Oregon
There are several ways people in Oregon may get health coverage.
Employer-sponsored health insurance
Many people get health insurance through their job.
Small employers
- Businesses with 50 or fewer employees may qualify for small-group health coverage.
- Small-group plans are available year-round, so employers can enroll at any time.
- If you have at least one employee who receives a W-2, you may be able to buy coverage for yourself and your employees.
Large employers
Businesses with more than 50 full-time equivalent (FTE) employees are generally required to offer health coverage that meets federal standards.
Oregon Health Plan (OHP)
OHP operates Oregon's Medicaid, Children's Health Insurance, and Basic Health Programs.
People and families with lower incomes may qualify for free or low-cost coverage through an OHP program.
Private health insurance
People who do not have job-based coverage, Medicare, or OHP may be able to buy health insurance through Explore Health or directly from an insurance company.
Many people qualify for financial help to lower:
- Monthly premiums
- Out-of-pocket medical costs
American Indians and Alaska Natives may qualify for additional protections and savings.
Medicare
Medicare is a federal health coverage program for people who:
- Are age 65 or older
- Have received Social Security Disability benefits for 24 months
- Have end-stage renal disease (ESRD)
Association health plans
Some small and mid-sized businesses join together through association health plans.
These plans may offer lower costs or different benefit options, but they may not cover all essential health benefits or pre-existing conditions in the same way Explore Health plans do.
Health reimbursement arrangements (HRAs)
Some employers help employees pay for health care using Health Reimbursement Arrangements (HRAs).
An HRA allows employers to contribute pre-tax money that employees can use for eligible medical expenses.
Some employers may offer an Individual Coverage HRA (ICHRA), which helps employees purchase their own individual health insurance plan.
Having an ICHRA may affect:
- Eligibility for financial help through Explore Health
- When employees can enroll in Explore Health coverage
Small-group coverage
Small-group coverage works differently than individual coverage.
Unlike individual plans, which have Open Enrollment periods, small-group plans are available year round.
Businesses with one to 50 employees can buy certified small-group medical or dental plans from insurance companies offering coverage in Oregon.
Financial help and employer coverage
If an employee is offered health insurance through their employer, they may not qualify for financial help through Explore Health.
This depends on:
- The cost of the employer plan
- Whether the plan meets federal coverage standards
For 2027, employer coverage is generally considered affordable if employee-only coverage costs less than 10.22% of household income.
Family members may still qualify for savings if family coverage offered by the employer is too expensive.
Coverage for family members
Some employers help pay for employee coverage but do not contribute toward family coverage.
In some cases, spouses or dependents may find lower-cost coverage through:
- Explore Health
- The Oregon Health Plan
Financial help may be available depending on household income and the cost of employer-sponsored family coverage.
Don't have employees?
If you are self-employed or do not have employees, you may still qualify for individual health coverage through Explore Health.
You can enroll:
- During Open Enrollment
- During a Special Enrollment Period after certain life events
- Year round through the Oregon Health Plan if eligible
Common qualifying life events include:
- Losing other coverage
- Getting married
- Having a baby
- Moving
Small Business Health Care Tax Credit
Small businesses with fewer than 25 full-time equivalent employees may qualify for a federal Small Business Health Care Tax Credit.
The credit is available for businesses that:
- Buy certified small-group medical or dental plans
- Pay at least 50% of employee premium costs
- Meet employee and wage requirements
Eligible businesses may receive:
- Up to 50% of premium costs for small businesses
- Up to 35% for eligible nonprofit organizations
The tax credit may be available for up to two consecutive tax years.
Who may qualify for the tax credit?
To qualify, businesses generally must:
- Have fewer than 25 full-time equivalent employees
- Pay average annual wages below the federal limit
- Contribute at least 50% toward employee premiums
- Purchase a certified health or dental plan
How to claim the tax credit
Step 1: Buy a certified small-group medical or dental plan from a participating insurance company.
Step 2: Tell your insurance company or agent that you want to apply for the Small Business Health Care Tax Credit.
Step 3: The Marketplace will provide a letter confirming the plan is certified.
Step 4: Include the confirmation letter when filing taxes. The IRS determines tax credit eligibility.
COBRA and retiree coverage
Some people may also have coverage through:
- COBRA
- Retiree health plans
These types of coverage can affect whether someone qualifies for financial help through Explore Health.
People losing COBRA or retiree coverage may qualify for a Special Enrollment Period.
Need help?
Explore Health can help employers and employees:
- Compare coverage options
- Preview Small Business Plans and Costs
- Understand financial help
- Find certified plans (2027 | 2026)
- Connect with licensed agents or enrollment help
Free support is available.