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Employee Insurance Coverage

OHI182OHI182 9 Posts
in Benefits & Leave Vote Up0Vote Down
Can you provide single-coverage health insurance to some employees and family coverage to others? These employees are in the same job class. Doesn't this fall into the basis of discrimatory or non-discrimatory for both IRS and DOL. Any advise would be greatly appreciated. Thanks!
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Comments

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  • Theresa Gegen TXTheresa Gegen TX 814 Posts
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    Since you haven't stated any basis for why the company would want to offer different coverage to different employees, there probably is a problem with discrimination. Without knowing the basis for the distinction, its hard to say whether it is discriminatory. I can't imagine a non-discriminatory basis off the top of my head, but there may be one.
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  • patbpatb 6 Posts
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    If what you mean is can you pay for single coverage for single people but pay for family coverage for those with, either or both, spouse and kids it's legal. It's non discriminatory to write your eligibility to state the company will pay for coverage for all persons listed on the employee's Federal Income Tax Return. We've done it for years. If you are passing along some portion of the cost to the ee I'd suggest it be the same percentage of the cost for each category, just to be on the safe side.

    We're self funded but I don't know of any laws or regulations that would make it different for an indemnity product. Having said that, with the new HIPAA regulations and the complexity of ERISA, I'd suggest you have a lawyer look at your plan.
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