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Advice Needed on a Health Care Matter
Benefits & Compensation
Advice Needed on a Health Care Matter
Exchange ideas about health plans, retirement, work/life benefits, and employee assistance.
Hi there:
I have a single employee, currently enrolled in our group health plan, who is getting married to someone who does not work with us in April. He wants to drop our health insurance group pl
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Forums » Topic Forums » Benefits & Compensation » Advice Needed on a Health Care Matter
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Advice Needed on a Health Care Matter
posted at 12/15/2009 5:37 PM EST
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Posts: 1
First: 12/15/2009 Last: 12/15/2009 |
Hi there:
I have a single employee, currently enrolled in our group health plan, who is getting married to someone who does not work with us in April. He wants to drop our health insurance group plan in favor of joining his bride's group plan with her employer when he gets married. But he has asked our business owner if we would be willing to pay his new wife's monthly premium. He's arguing that it would be cheaper for the company to do this instead of carrying him and his wife on our health care, and our boss likes the idea. Is this legit? I'm worried that it might be discriminatory (wouldn't we have to offer to pay for all our employees' spouses health care premiums?) Are we going down a road we don't want to travel? Or is this a clever way to reduce health care costs that we should pursue? I'm not an HR expert, just the poor guy assigned to these duties in the office, and I really could use some guidance. Thanks |
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Advice Needed on a Health Care Matter
posted at 12/15/2009 11:55 PM EST
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Posts: 155
First: 8/24/2009 Last: 2/9/2010 |
IMHO on the surface it isn't illegal necessarily but I agree it would be a bad precedent. While you wouldn't necessarily have to do this for all employees the second you start doing it internaly you open the door for ERISA and IRS issues.
I would simply say no, that is not a practice your company wishes to engage in. |
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Advice Needed on a Health Care Matter
posted at 12/16/2009 2:43 AM EST
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Posts: 186
First: 4/23/2001 Last: 4/14/2010 |
The only thing I would add is that many companies do have a policy that if the employee can be covered under a spouses' plan and enroll in that plan they will pay the employee a monthly amount to keep them off the employer's plan. Maybe your PTB would like that option to cut overall healthcare costs. Of course, any of these options may be out the window with the Obama healthcare reform. |
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Advice Needed on a Health Care Matter
posted at 12/16/2009 3:15 AM EST
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Posts: 2146
First: 2/15/2006 Last: 9/14/2011 |
Agree that the most common things I have seen are (1) for the employer to pay some type of stipend to employees that are covered elsewhere, usually less than the cost of their coverage; (2) employers to charge an upcharge for spouses who are eligible for coverage elsewhere (my husband's company does this) and (3) to increase the employee's salary by the amount they would pay or some portion of it.
Option 3 can be a bit harder in the future, because it is harder to take away. For example, assume the spouse quits her job and becomes a stay at home mom with no benefits and your employee now wants to be on the plan. Do you (1) lower his salary or (2) charge him more for benefits than others? I do know a company that has an initial written election on whether the employee wants to be covered and any coverage chosen after that point is paid 100% by the employee-- since their initial salary took no coverage into account. But again it is hard to administer....and most of the time the employee forgets that election |
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Advice Needed on a Health Care Matter
posted at 12/16/2009 3:19 AM EST
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Posts: 118
First: 2/28/2008 Last: 7/29/2011 |
We pay employees one half of what we pay for their health insurance if they decline it. To decline they have to provide proof of other insurance. It works out well for us and our employees. |
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Advice Needed on a Health Care Matter
posted at 1/12/2010 4:27 AM EST
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Posts: 9
First: 9/13/2006 Last: 2/22/2011 |
Have you checked to see if both of them keeping single coverage at each employer is cheaper than both on one plan? If so, he isn't going to pick up family coverage your organization anyway - he just might be using this as an opportunity to make some extra money when it's actually more cost effective for each to keep their own coverage at their own places of employment. |
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Advice Needed on a Health Care Matter
posted at 1/12/2010 7:22 AM EST
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Posts: 4
First: 1/12/2010 Last: 2/4/2011 |
Based on my 26 yrs exp in HR, I would not pay benefits premiums for someone in a non-company Plan. Why? (1)if done, could be used against you in a legal suit as "past practice"; (2)possiblity it is discriminatory or that a case could be made accordingly; and (3)as mentioned by someone else here, it has federal regulatory impact.
NOTE: Pending federal healthcare reform this all may change. |
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Advice Needed on a Health Care Matter
posted at 1/13/2010 3:03 AM EST
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Posts: 7
First: 8/29/2000 Last: 4/21/2011 |
Employing an Opt Out Policy is the cleanist way to go. That way you are giving the same opportunity to every employee and you can set the amount to pay at your descretion each year. The suggestion of 1/2 of what you pay is good, but is also generous compared to what most companies pay. Having them provide proof of insurance coverage is essential to keep employees "safe" from getting hit with unexpected costs that could cause them to have to file bankruptcy to pay for their health bills. I have used an opt out program in the past and it was well received by the company and its employees. |
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Advice Needed on a Health Care Matter
posted at 1/19/2010 7:35 AM EST
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Posts: 1
First: 1/19/2010 Last: 1/19/2010 |
We just started a Health Credit Opt-Out plan for the employees. It is being offered to all the employees, however, they must provide proof of coverage with their spouses or other health care. If you are not married, perhaps this credit is not for you. If you can health insurance for the price we are given you, good luck. Our rates for health insurance increased by 25% and with all this health care reform who knows what will happen. We offer $166.67/month up to $2,000 a year. |
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Advice Needed on a Health Care Matter
posted at 1/20/2010 10:55 AM EST
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Posts: 6
First: 10/2/2002 Last: 3/8/2011 |
You're right, paying him for his portion of premiums covered by his wife's health plan is a bad idea. Instead, you may consider offering a set amount to ANY employee who chooses to OPT OUT of your health plan. This would provide a benefit to him for not being in your health plan and provide funding if he chooses to enroll in his wife's plan. |
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