Required to provide insurance for all employees?
awhiteside
4 Posts
I am on the Board of Directors for a SMALL non-profit - only 4 employees. We have one employee who desparately needs insurance benefits, one other who will enroll if offered. We are contemplating paying the full amount for the employee only, anyone who wants family coverage will have to pay it on his/her own. Problem: One employee is on TENNCARE (the State version of Medicaid) and would be on the losing end if she has to pay for the family insurance, but if she is eligible for insurance at work, she will not qualify for TENNCARE.
Any suggestions on how to assist one employee without causing a burden on another?
(I know, decisions should not be made based on "persons"; but we would really like to provide insurance for our employees since salaries are very low.)
HELP Please!
Comments
I would recommend talking to a benefits insurance broker in your local area. They might have some ideas for you. And be able to tell you the cost of coverage and whether the group would be coverable at all.
That said, we have 25 employees and to get small group coverage, our carrier requires that 100% of the eligible (fulltime) employees be covered. So I suspect that with only 4, you will have to cover them all. Most of the govt provided health care (TriCare for military, State Medicaid, Medicare, etc) have very strict rules on providing care when there is an employer who is already doing so or available to do so. Is it totally out of the budget to cover the whole family? I suspect that answer is yes, but it is a consideration.
On the one who desparately needs benefits, is it because of a health/medical issue? If so, you are going to have to disclose that on the medical questionnaires which will potentially raise any initial quotes and costs for everyone on the same plan. I would disclose it upfront to the broker if you know about it. Or is it because of the cost? Has that person looked into private insurance through their current insurance agents (car, life, house, etc), through any professional associations, etc?
Sounds like an unwinnable situation unfortunately. Either way, one employee is impacted negatively unless your nonprofit can afford to foot the insurance bill for the whole family.
If you do pay as accounts payable, you need to look into the taxability of it to the employee.
If you want to keep the same "benefit" for all employees, you need to be careful with the Medicaid plan participant. It might be illegal for the employer to pay for the premium (or incentivize it in any way), even through accounts payable. I know it is with TriCare and Medicare. Therefore, the employer may not be able to pay out for the employee on Medicaid.
Thanks for your responses. We actually had already talked with a broker, who will insure us with only four employees. After much debate and wringing of hands wanting to do what is best, we had to take a step back, look at our objective and go from there.
The organization is a non-profit health care clinic that offers health care to working uninsured, we felt that we had an obligation to provide healthcare benefits to our employees - otherwise, we were actually adding to the problem!
We decided to go ahead an offer health insurance, paying 100% of the premimum for the employee. And, we decided, that since the state plans are actually for individuals who don't have access to healthcare, we would not be good stewards for taxpayers if we made a conscious decision to "allow" someone to stay in the system.
Hopefully we won't lose a good employee, but we chose to do what we felt was best.
Thanks so much for your responses!