Posted on 11/09/2005 10:32:48 AM PST by doc30
I have a question for the many, knowledgeable freepers out there regarding employer health insurance. Open enrollment is upon us and this year, and the company I work for has sprung a new twist that shockeked myself and my coworkers.
As in past years, we are expected to shoulder more of the burden of our health insurance premiums and this year is no different with an $80 to $120 increase in our protion of the monthly premiums. Nobody likes it, but it's a fact, but that's not what concerns me.
We are offered employee+spouse and family plans, each with its own, higher, repective premium. THis year, our employer is charging an additional $50 per month for a spouse or family plan if the spouse works and has health insurance, regardless of cost or coverage, offered as a benefit from their employer. This is in addition to the higher premium for just having a spouse! We are expected to turn in an affidavidt signed by the employee and their spouse providing the name and HR contact for our spouse's employer or stating that the spouse is non-working. Our employer claims that it is spouses that are responsible for most health care usage and want to charge spouses that decline benefits elsewhere.
What do you fellow freepers think about this? Is it even legal?
I'm not sure about the legality (though doubting it is illegal to charge the surcharge, I think it is stupid). Nearly all insurance plans have coordination of benefits provisions to prevent insureds from getting multiple indemnification for the same covered loss. Insureds who attempt to circumvent these provisions are committing fraud, and subject to criminal prosecution when discovered.
So, even aside from avoiding your employer's surcharge, it makes no sense to buy double coverage. Better would be to get family coverage for all at one employer, or individual coverage from each employer. If you have no minor children to cover, I would suggest the latter.
Well, my wife doesn't work so it isn't an issue for me. But it is an issue for some of my co-workers.
Re-read the post. It wasn't crystal clear, but it looks like the question is: Can the Employer charge an extra $50 if the spouse DECLINES coverage at her ER and take coverage at his ER.
Do you mean that some companies will not offer benefits if to their own employee if that employee's spouse is offered family coverage elsewhere? What happens if both spouses work for differnt companies but with the same policy regarding benefits? No one can carry?
What happens when the spouse works for an employer that provides very poor coverage, but requires the employee to pay a very large premium? For some people, that, in theory, could mean a premium as large as their paycheck if they work near minimum wage.
Send your employer a certified letter with this exact wording: " Where is this money going?"
Carbon copy an attorney friend.
They won't bother you again.
What they are doing is against federal laws.
"Beats me. I don't have any health coverage."
I hope you have a nice big savings account, then. I went without health insurance until I was 40, then bought coverage. Five years after that, I ran up a total bill for a bout with viral encephalitis that exceeded $100,000. I thanked myself for buying that coverage.
I don't work outside the home and every year I must sign a Continuation of Benefits for my husband's company stating that I do not work and have no other coverage. We don't get charged more because I stay at home.
No, they will offer benefits, just not to the spouse if she is working and has benefits at her employer. One of the spouses will carry children if any and that is left up to which spouse that wants to carry the dependents. If both spouses work for a company with the same type policy, the must each cover themselves and one spouse will cover the children. But it doesn't matter which one.
As a benefits rep, I have come across this many times and listened to much heartache because usually one spouse will have much better benefits than the other. And it's usually the companies that offer better benefits that do this. I believe the Michelin plant here in Greenville SC does this.
I am contributing more than $300/month for healthcare this year. I opted out next year. I get $74/month in return. Not such a bad bargain. It about covers the tax increase.
We have to pay an additional amount if our spouse has available health care coverage at their employer and choose to be carried on ours. Spousal surcharge. Also, if you've osed tobacco at anytime within the last 12 months, you pay a smoking surcharge, which you have to pay until you have not used tobacco for 12 months. (includes smokeless tobacco). If you lie about any of it, you get immediately dropped from coverage, must pay anything they've covered (don't know the time limits on that) and you cannot pick up coverage for some amount of time.
Paying the extra spousal surcharge on my side is still less than my hubby choosing insurance from his work, even single coverage. The coverage offered through his employer in fact is so high I think it discourages people from opting in for coverage.
Since people think that health care is a requirement now, and since insurance companies are so expensive and invasive to everyone, and since medical professionals charge more now because the majority of people have some type of coverage (private or government) we are stuck with almost having to have coverage to even see a doctor.
Insurance companies are now some middle man in the way of affordable healthcare. We don't need government coverage for healthcare, we need to get away from insurance and go back to paying the doctors ourselves.
See if you can get your company to get high deductible insurance, or opt out and get the insurance yourself.
This is very common. Your company is trying to keep its costs down and that is one way of doing it.
It is caused by new trend of employers paying a rebate to employees that opt out of health care coverage.>>>>>>>>
When and where did this start? If my employer would pay me the amount they pay for my insurance, I would almost certainly refuse coverage and my wife and I would pay our own bills, as it is it takes most of the year to meet the deductible anyway.
In any event, the Employer cannot charge extra premium to the employee for any usage of the plan or charge premium if the employee declines coverage for dependants. The employer would run afoul of the HIPAA privacy laws for ever asking about any claim filed by an employee.
Either way, the employer is running a huge risk of a lawsuit and federal penalties.
My point was that it appears that the ER is doing none of those things.
Federal benefit rules requires that if one employee in a class is offered insurance, every employee in the class must be offered.
My company pays 100% of the premium for the employee and I pay 100% of the premium for family coverage.
Before this program began the employee that opted out of employee coverage got nothing. It makes the cost of the benefit equal for all employees.
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