Reimburse for outside health plan coverage?

Caroliso

Do any of you have a policy in which you reimburse an employee if s/he is covered under their spouse's plan or other plan that isn't yours? If you do, what is your policy when both spouses work for you, if they elect a family or 2-person plan? Do you reimbure the "dependent spouse"? What is your rationale?

If you don't have such a policy but have an opinion and a rationale, I'd welcome that also.

Thanks,

Carol

lukkieseven

At my previous company, we had a certain dollar amount ($100)that we gave to staff who were covered under a different plan. At my present company we do not. When a husband and wife both work at our company, they each are enrolled separately. It's cheaper that way, because we pay approximately 75% of the premium for an employee, but nothing for dependents.

Hope that sheds some light.

ritamcguire

We do not give any reimbursement to an employee whose spouse is on another company's plan. If both husband and wife work for our company, we do allow both to enroll individually since this is much cheaper for the employees.

HRCalico

Current company - we allow spouses to enroll separately (we pay 90% EE premium and only 50% family).

Previous company - we were paid ($250/mo comes to mind, and it was hmm 4-5 yrs ago) for . . . . I'm not sure if it was enrolling in another plan or just not taking insurance. I do remember I made a killing as a single, healthy person with my own health insurance. I don't remember if we had to submit proof of coverage.

Previous nonprofit life: we paid EEs x dollars per month (again $250 comes to mind) to purchase their own health insurance or pay out of pocket medical expenses. I wasn't involved with the administration - there must have been some sort of 125 plan going on, because if it was medical, they paid it out pretax and if it wasn't, they taxed it.

My current president has toyed with this idea but seems to think we need to have proof of coverage or otherwise we're somehow liable if something catastrophic happened. Anybody know anything about that? (Carol, I hope this isn't a hijack of your thread - it sort of ties in!)

Some think it's unfair that we pay so much more for an employee to have their family on than an employee that elects single coverage. (Or maybe they are single.) The EE with a family is getting more benefit than the single EE. I guess it's true, but it seems petty to me. "Fair" seems to mean "me first and best", not necessarily "everybody equal." Not everybody is equal!

Caroliso

>Previous nonprofit life: we paid EEs x dollars
>per month (again $250 comes to mind) to purchase
>their own health insurance or pay out of pocket

Hijack away, Cali!
Re proof of coverage, I would think it would make sense to require proof of coverage in any event, so you are sure that is where the dollars are going. I don't know anything about the legal liability. We require it.
As to paying folks to put it in the bank for a (sick and) rainy day, I've never heard of that before. I wouldn't touch it, but I'm a proponent of people having health insurance, as screwed up as the system is.
Do NOT get me started about the individual vs. family benefits, who gets more, issue. I couldn't believe it when someone first raised it at my company, but I'm not surprised anymore. Some single folks here claim they are discriminated against because the company provides more $ benefits for EEs with families (health plan coverage is % based, life insurance is more for EEs with dependents, we have paid FMLA which is most commonly taken by people having kids, yada yada). It did get me thinking about the purpose of benefits, which for us are not that you're entitled to a dollar amount because you're an employee, and each EE should get the same dollar amount, but rather that some benefits are based on need, and what is going to be supportive of a broad range of circumstances so that people with different situations can work.
Okay, I got myself started! That's another whole thread.

nietra

We pay $300/month per full time employee into a cafeteria plan. It's then the employees choice as to how the money is spent... our policy, a personal policy, daycare, unreimbursed medical, AFLAC, etc...

Caroliso

Several of you posted that if you have both spouses as your staff, you require they take two individual plans. I'm interested in when your policy is to reimburse for an outside plan, and the spouses on your payroll have kids. Obviously it now makes sense to take the family plan. Do you reimburse the "dependent" for the portion of the out of pocket premium cost they pay for their own coverage?

I know it sounds convoluted, but the way I think of it is: if the "dependent" employee were covered on the plan of a spouse who worked at another company, we would reimburse them a portion of the cost. Isn't it the same thing if the spouse's plan in our own company?

ritamcguire

Medical coverage is a benefit that we GIVE our employees. It's not a right that they can demand. Why make it any more complicated than it has to be.

We pay 95% of the employee's medical coverage and ~70% of any family members he/she wishes to add (overall a very nice benefit). End of subject. If they want to get coverage somewhere else for themselves or their families, that is a RIGHT they really do have. Our employees that have a spouse also working at our company can take two employee-only options versus the family option. Thus the couple gets 95% of both their medical coverages paid for. Our employees that have a spouse working at another company look at the combined options offered by both companies and take the options that best serve their family needs, whether for financial reasons, medical reasons, or whatever reason. They usually opt for single coverage at each company, as that is more often the best option financially. If kids are involved, the employees decide which company provides the best benefit options for their children. It's their choice. This entails no extra paperwork on our part, no figuring out percentages, no extra time for our benefits department, no payroll issues, etc. This appears (at least to me) to be the fairest and most logical way to handle this issue.