FORCED HEALTH BENEFITS

pattyo

An employee's husband is going to be eligible for health insurance through his company. He is currently on ours. He doesn’t want to go on their insurance because our plan is better and less expensive. He mentioned this to his boss and was told that he didn’t have a choice. Do you know if companies can force their employees to take the company’s insurance plan over their current one and thus actually force them to pay more for insurance?

irenesmsaclaims

He can waive coverage through his employer's plan, especially if it's contributory. They cannot force them to enroll. His boss may be confused with the inability to drop the coverage without other coverage, or because of a cafeteria plan election, but this is not either situation.

He should, however, sign a waiver due to other coverage, to preserve his special enrollment rights under HIPAA in the future, should he lose coverage under your plan.

Don D

We don't force employees to do either; however, at least twice a year each employee must provide an update of their spouse's inability to obtain group coverage at place of employment. If a spouse has coverage available but does not take it, or opts to cover spouse on ours IT WILL COST THEM ALMOST TWICE AS MUCH as it does to cover the spouse who has no coverage available.

One of out goals (duh) is to get people off our plan if they have coverage available elsewhere. It's not our concern what it might cost them for other coverage.....we just want them off ours.

marc

It is my understanding that you can require them to take your coverage if you pay all the premium. We do that in order to maintain a big enough group to get better rates than otherwise would be available.

irenesmsaclaims

If you can get them to sign the enrollment in Marc's situation, which of course they should, then good. But you can't force them to enroll, even if that's the policy under the contract/coverage. If they absolutely won't, then the employer needs to get a waiver. Either way. I remember an elderly employee who would not enroll in a 100% employer paid LIFE insurance plan, so I got a waiver. He was ranting about the company/government/aliens getting into his life. Want to bet whose relatives would be coming around in the case of an unfortunate demise??

pattyo

Thanks for all the info. His concern was having to pay for health benefits when he didn't want or need them. I'll forward all this on.