When offering medical/dental benefits, can an employer require an employee to take coverage under their spouse's plan (if they are married) rather than enroll on their own employers plan? At face value, that sounds like discrimination based on marital status to me!


  • 10 Comments sorted by Votes Date Added
  • Many companies refuse coverage if the employee can get coverage elsewhere (spouses and in rare cases grown children who are qualified under their parent's plans). Most give the employee some type of compensation though to help discourage lying.
  • We do not require the employee to take the spouses's coverage. We explain the benefits that our plan provides and if they decide to take the other plan, we compensate them.
  • At my husband's company, if the employee's spouse is eligible for coverage of their own and opts to go with dependent coverage on the employee's plan, the employee is chaged a penalty of $100 a pay period. Of course the company has to know where the spouse works and that coverage is available, but who knows what they would charge someone they caught lying. We make it easy for them and are both covered on my plan. No penalties here.

  • FHRB: I agree with you, that option sounds like discrimination to me too. Apparently, based on the responses received this option may simply be up to each employer. I hate to say this, but I can't believe the "government" is not involved in this...
    It is my opinion that if an employee meets the eligibility requirements for the company plan then they should be allowed to enroll in the plan if they want regardless of what type of plan their spouse may have. I can see this as a law suite waiting to happen. And the Judge says “Mr./Ms. HR person, please explain to me why you would not allow this employee to enroll in your company health plan when they met all of the requirements.” To me the HR Dir. has some fiduciary responsibilities to ensure that this type of situation does not occur.
    Just my two cents...

  • I am in total agreement with you. Certainly sounds discriminating to me as well. That's why we make our plan choice voluntary.

    Remember the days when the dependent coverage for children had to be with the father's plan?
  • Lots of things are discriminatory, but not necessarily illegal. Every employee of the employer who uses this option is treated the same regardless of sex, religion, color,.... so it is not illegal.

    A single employee will not have the same options as a married employee, and that is the only difference. However, the single employee might feel that they are the ones discriminated against. After all, the married employee might be able to get coverage through the spouse for half the cost (and would have anyway) and still get a reward of $100 to boot.

    Organizations have the right to set up their benefit plans as they choose, providing it doesn't cause illegal discrimination. They can choose not to cover certain conditions most employers cover, while covering some conditions few employers cover. They can choose how much they pay and how much the employee pays, and they can choose other ways to reduce their costs. The employer whose employee opts to go on the spouse's plan may save as much as a $1,000 a month or more, even if they are paying the employee $100.

    Until they change the laws to say that you can't discriminate against married or single individuals, this is not illegal. It is not always smart, but it is not illegal.

    Just my 2 cents.

  • I spent quite some time researching this and did not find anything to indicate you could or could not have this requirement. My 2 cents, I don't see why you would want to and take the chance someone would cry discrimination.
  • I think I read somewhere that you couldn't do this at least for TRICARE recipients. My recollection could be faulty, however, it seems to me that if the feds forbid it then it won't be long before what you are asking will be against the law if it is not allready. I would seek legal advise.
  • We are not looking into doing this. One of my colleagues asked the question and I thought I would consult the expert panel!
  • Some of this has to do with the way your policy is written. Some companies specify if an employee is already covered by a plan, they cannot join the company plan (double coverage). We don't specify this in our plan and let employees join if they wish even though they may be covered elsewhere.

    Check with your broker to see how the plan is written.


Sign In or Register to comment.