Mandatory Health Insurance

janselm

Only been in this job two months and this is all new to me. We pay full cost for EE only medical coverage. Can you make it mandatory for employee to enroll in medical coverage? I have never heard of anything like this, but this is what my insurance broker is telling me. If we are paying for it they have to take it. I played devil's advocate with her and asked what if they had a religious objection to medical treatment? I haven't heard her response to that yet. What do you all think? It seems crazy that we would make someone enroll in a medical plan if they have one available to them elsewhere, not to mention the fact that it is a waste of money for us if she doesn't want it.

Thanks,
Jennifer

plynnl

Our medical/dental insurance coverage requires "Opt Out" forms for those employees enrolled in other plans and do not want to participate in our plan.

cnghr

I just ran into this personally; we were just going to keep my husband on my plan and not enroll him in the plan with his new employer, but they told us that because the employer pays 100% of the premium for the employee, he HAS to enroll in their plan, even if he has other coverage. He can opt out of enrolling me, but he has to enroll himself.

System

We pay 100% here as well and this is the first I have heard of requiring ees to enroll. :-S We have several people who are not on our medical insurance but have life insurance through the same company, so our broker is aware of them. When the Bank first opened it was 'requested' that the inital employees join due to health issues with our Executives and the need to get some younger and healthier people into the plan.

I am interested to see what the final outcome of this question is...

Dutch2

Prior to changing to self insured a few years back, our former insurance provider required all eligible employees to enroll in the plan. This is how our policy contract was written with them. We too paid 100% of employee cost.

stilldazed

Agree with Dutch that the 'mandatory' part comes from your company's contractual obligation to your insurance company to maintain a minimum census. We have had the same in the past (mandatory coverage for coverage fully paid by my company) and have failed to enroll some folks because the insurance company required an enrollment form and employee signature. Our experience was that the insurance company didn't take any action against us, didn't cancel our policy, and became somewhat permissive with us on the issue. My thought, which is what I shared at the time with our company, is that mandatory coverage is automatic enrollment. If the employee has to sign to confirm enrollment, we don't have mandatory coverage. Probably risky, but it worked. And we no longer have mandatory coverage in the contracts.

In defense of the concept, insurance companies do want a minimum census with the employer to help spread their risk, and employers want their insurance costs as low as possible, so employers also want insurance companies to spread their risk. Not following through a mandatory enrollment contract by allowing some folks to decline insurance may mean that your company doesn't make your target minimum census, that you insure only sick people, and that ultimately your costs increase.

best wishes.

NaeNae55

It is a common insurance practice that has been going on for years. Many carriers require 100% enrollment to keep certain costs down and avoid adverse selection. Whether the employer chooses to pay 100% or not is up to them. I believe most employers either don't go with 100% enrollment clauses, or will pay the employee portion. This may be covered by a state law, but federal law does not prohibit these kinds of contracts/requirements.

Good luck!

Nae