Anyone out there know about Insurance law?

In the past hubbies insurance was very generous. Now they're doing some stuff that just doesn't seem fair (but then again, we know about that). I have coverage through hubby AND through my work.

Now hubbies work is saying that if a spouse has coverage through their employment they will no longer be eligible through hubbies. So pretty much the upper management folks whose wives can stay home and not work get their insurance paid for, but the folks lower on the ladder who need two incomes do not. They're getting an extra $600 a month benefit that hubby is not.

Can they do that?

I know to some I sound ungrateful, but I have had many medical problems, hospitalizations and bills. It was always a relief to know that once the deductibles were paid ($2,000 a year) everything else would be covered 100% ( not including prescriptions).

Plus, hubby HATES his job. But our local economy is even worse than nationally. What has kept his morale somewhat up is knowing that he was providing good benefits for his family. I'm in management and know the cost of health care, so every year he didn't get a raise I could placate him with the what the value of his insurance was. Now he is feeling very bitter.

It seems another case of the rich get richer and the working stiffs get stuffed again.

I don't know anything about the law, but I do know this is becoming common, and just from the fact that so many companies do that, I'd assume its legal. My hubby's company has a thing where if you sign up a spouse for the company's health insurance who is offered insurance through their job, you have to pay a penalty per paycheck (although its only $50 every 2 weeks, and you are still allowed to get the double coverage or only choose the spouse's coverage option). Your spouse can get dental without the penalty though (so we did that).

It was a better deal for me to just stay with my employer...the double coverage wasn't going to be helpful. Another thing they are doing to cut health care costs at some workplaces is to have a low premium portion if just the employee signs up for health care, but a huge portion of the premium due if you also sign up your spouse or kids (my company did this for this year, as I think they saw 40% premium rise last year and 20% this year!). Sucks doesn't it? I could go on a huge rant about this Obama healthcare thing...I laughed when I heard them say it wasn't going to raise our costs...and I was right. I think its still just the beginning, as all these healthcare cost increases right now are just because they are predicting rising costs, not that they have even risen yet...so, expect even more cuts and increased healthcare costs in future years.

Something I wish we were able to do was ask for detailed info on the company's insurance plan before taking a job...as far as I know, asking for this, if even allowed, would be a red flag. I had no idea when I signed on with my company what type of plan it was, how much I would have to pay, etc...just that it was offered. I got very lucky though that its a pretty great policy for little out of pocket. The copays add up when you go to the doctor weekly and fill 9 rxs a month though! If I had the ability to compare company's healthcare plans, that would be a HUGE factor in a job decision for me.

Best wishes and I'm sorry you're having to deal with this....it's one thing to have had a bad deal all along, but I hate when they change the rules on you. A lot of companies really have no choice though...they are trying to cut where they think employees will feel the least impact, but its never going to be fair no matter what they do. One thing you may be able to do is write an anonymous letter expressing your view to the company, and letting them know how much this will impact you (ie. give a dollar amount). If they get enough complaints it may make them want to change it back.

Thans, Kate. Hubby and I have had a couple days to Settle down. We are reminding ourselves that we are very lucky in the we both still have insurance. Our son qualifies for public aid based on his disability income and actually the public aid will provide better insurance than what he had privately through hubby. It will include eye and dental.

And as for being upset when we see his bosses getting new caddies every year, their wives getting bad plastic surgery, we figure they pay more income tax then we do and are paying for Roberts insurance anyway.

So please don't burst my evil bubble and tell me that they have fancy tax lawyers and probably pay less in taxes then we do. At least they have to pay those lawyers!

para,

very common for employers to require employees to have spouses or other dependants covered under their own employer's plan. state laws vary, but it's legal.

state insurance comissions looked at this early on as a way to cut down on duplicate insurance payments for claims, but it trickled for a way for employers to cut down on the number of lives they need to insure.

i do think, you'll have to check your state laws and summary plan document from the employer that if the spouse's insurance is sub-par and offers less of a benefit or the cost is more, they may be required still to carry you. if there is not equivalence, then i think you might have a case. this is where the thing about spouses comes in.

the wife, for example that doesn't work doesn't have access to insurance without undue financial cost or lesser benefit--therefor she is eligiable under her husband's employers plan.

and, if they are driving caddies, then they aren't doing that great (sorry, not a cadillac fan, lol). actually, they need to get a better tax attorney--you could lease better cars for less.

-mgb

For the past 2-3 years, during the enrollment period for insurance, my husband has to validate that I am not eligible for health insurance by my employer. This is easy since I am not employed. I am surprised that this hasn't happened sooner.

I think the employee should receive compensation for the amount of money which is not used to towards coverage if they are not actually getting covered. I bet there are attorneys contemplating this.

Some companies may give a small payment in lieu of benefits, however that defeats the role of employee benefits such as healthcare.

If you offered a person the full amount of insurance coveage, most likely the premiums are in the 5,000 range. Many people would be just tempted to take the "pay," despite it technically it is not payroll. And in the event of catastrophic or just about most medical procedures, they would be in high debt very quickly. If they would have chosen the healthcare benefit, then they would avoid financial disaster.

Companies do not want to make a benefit a payroll practice for this type of reason. Depending on healthcare plan, there are tax implications as well.

If I added an employee, I surely would not give them an extra 7K (individual) just because they decline a plan. Either take the benefit, or nothing. Health insurance is that--insurance for health problems. It's not payroll. In many cases the real dollar value of the plan is worth much more than what an employee makes a year (or a lifetime).

Just my .02.
mgb

John McCain was a proponent of taxing benefits (insurance) as income. We dodged a bullet there.

i'll have to double check this, but if i recall correctly,

mccain wanted to eliminated the corporate tax deduction for providing health insurance and obama wanted to tax health insurance plans (individually)which he and others called "cadillac" plans.

most of these high end plans are provided by unions and under union benefits. since the healthcare reform bill passed many unions have sought and received waivers from having to join mandatory enrollement--which is a direct undercut to the whole premise of "the law of large numbers." teacher unions are prime examples of extremely "rich" insurance plans.

since union plans are quite rich compared to non-union plans, the administration realized their constituency would be taxed--not only big-wig execs.

since i am a corporation owner, i would find it very irritating to be taxed on a plan that i pay for in order to stay alive, while a bargaining unit dodges the tax. that's why the "cadillac" plan and its terminology has died, unlike the increase in union exemptions.

what's good for gander isn't good for the flock.

but if i'm wrong on this, i'll take my medicine. as long as the gubment says it's ok.

Good point, Marc. In his younger days hubby was in a union. He would get so furious at the even younger ones who still lived at home with Mom and dad who didn't understand the value of a good insurance plan. They'd be offered the cadillac of health benefits but want to to strike because they weren't getting a "raise". Clueless as to how much the benefit was costing the company.

Plus, there were other times in our life, living from paycheck to paycheck that we may have taken the cash instead of the benefit. And in the long run, that would NOT have been in our best interest. But, poverty makes you make unwise decisions at times. Hello? Payday Loans? (what a racket that is! Should be illegal, but that's a different thread)

But no, I wasn't expecting them to give us the same amount that the benefit cost. That would obviously defeat the purpose, but for the $700 they were paying out, a token $50 a month would have been a nice gesture.

During the blizzard, hubby started digging at our house at 6:00 am. drove and got me from where I was was stranded and then took a three hour nap. THEN he went in to work. That never would have happened before. He would have pushed me out of the moving car at the house to get to work. He has taken one sick day in seven years.

But, his morale is shot and he said he's not going to bust his butt for them anymore since this is how little they think of Robert. I think it would have helped if they would have spoken to him about it instead of just putting a note in his paycheck. It's not a huge company, heck, hubby even goes and waters the bosses plants when they're gone.

Oh, and the one boss had a jaguar for a couple days. It was his dream car. But then his his ex went out and bought one just like it. She knew it was his dream car but that he would trade it in immediately when he saw hers and lose money and that's exactly what happened.