insurance

larobinson

We have health insurance that is paid by the employer for all employees and their families. The contract with our insurance provider states that all eligible employees will enroll. We have one employee who does not want to enroll because her current insurance (Tri-Care) is paid by the military and provides better coverage. She states that Tri-care will not serve as a secondary insurance. She tell us that if she takes our insurance she will lose out on the Tri-care coverage.

Is it legal for an employee not to take employer sponsored coverage in order to have access to Tri-Care or other coverage such as medicare or a spouse's insurance?

lnelson

Your ee is not obligated to take your coverage they can waive their right to it. They can enroll onto your insurance in the event they lose the current coverage (within 30 days from loss of coverage) or during your next open enrollment.

I would have them sign a waiver stating they are declining your coverage.

Lisa

marc

The important waiver you need to get is not from the EE, it is from the Insurance Company. If your contract says 100% enrollment, you will be in default if this EE does not enroll.

Some of our employees are Native Americans, who are covered by the tribes. They want to be secondary because of the obvious financial benefits to their system. They cover the expenses after our insurance is done. We also have a military wife - she had to take our coverage, but I am not aware that the Tri-care would not serve as secondary. You might want to check that out. It is a hassle to work with two different insurance carriers - maybe that is her concern.

In our case, if you do not use our coverage, you need to find employment elsewhere.

Parabeagle

A lot of it depends on your insurance carrier and how restrictive their contract is. Most companies I have worked for which require 100% participation are more than happy to let an employee waive off coverage if coverage is available from another source and will not press the issue. I suggest a friendly phone call to your insurance broker.

mwild31

I have a similar situation with our employee and her coverage under Champus (?spelling) - as already stated - work with your insurance company - they are the folks that need to waive insurance coverage. Our policy is also very strict (which it should be as having the employer pay 100% of the cost & 100% enrollment helps reduce employer costs), but with certain gov. insurance, they seem to go the extra mile. Good luck!