Monday, November 16, 2009

Can my employer legally refuse my spouse health insurance if he has coverage available if mine is better?

They will cover my husband for the 90 days until he is eligible for coverage through his new employer. His plan is from out of state and does not have many doctors and dentists in network as my plan. Also, my plan offers a dental and vision with doctors we already use. Can they really deny him coverage?

Can my employer legally refuse my spouse health insurance if he has coverage available if mine is better?
Like some of the answerers have said, it depends on where you live. Your best bet is to contact your state insurance department (link below), talk with the HR department, and even the insurance company itself. Even if you do manage to get your spouse on your health plan, you will probably have to pay for “plus one” coverage, which is often more than double what you’re paying now.





One factor that might be in play, again depending on where you live, is a rule that’s sometimes called “Coordination of Benefits,” which might make it okay for your husband to have insurance through his employer. For example, Ohio has a Coordination of Benefits rule that allows you to be covered by both plans. For you, your plan would be the primary plan and your spouse’s would be the secondary plan. The reverse would be true for your spouse. The insurance companies have to decide who pays for what. If you have children, the primary policy would be the one for whoever parent has the earliest birthday in that calendar year.





Barnes @ MostChoice


http://www.mostchoice.com/health-insuran...
Reply:They cannot refuse health insurance if you want him on your plan. Visit your HR office and talk first to the benefits manager, the the HR Manager and then if necessary the HR director.
Reply:Yes they can.





Atleast it is common in the Reno, NV area for a spouse's employer to refuse a spouse if they have their own insurance availability.





Don't know why; but, it happens.
Reply:Yes, he is legally supposed to use his health coverage and you can use yours. However, if you folks have children, then the kids can go with the parent who has the better benefits. But as far as this goes....it's his insurance he has to use. However there is a loop hole, if he cancels his insurance at his job, then he can go under your coverage. however the waiting and probationary periods will vary with different carriers.
Reply:I don't know if they can refuse him but they can make you pay for his coverage.
Reply:From what I know your employer is legaly obligated to offer "you" whatever he or she may have through the company. I know they can't deny you. But there might be some kind of weird loop hole if your husband already has his own. Get in contact with a lawyer.
Reply:Employers seem to have been allowed to get away with an increasing ammount loopholes with regard to insurance. I work for a sheriff's office and when I started they would not cover me until their open enrollment period began. They also have a policy that adds a surcharge if you place your spouse on your policy and your spouse is offered insurance through their employer. It is sick that everyone who works is not covered.
Reply:Call the department of Insurance in your state. I suspect the laws vary from state to state considerably.
Reply:Speak with your state's department of insurance, as each state has different rules.





However, generally speaking, your employer has the right to deny a spouse or domestic partner coverage if s/he is eligible for her/his employer's sponsored health plan.





Traditionally, employers have not selected to do this. I understand that the pratice is becoming more prevalent as health insurance costs continue to rise. If employers are concerned about health insurance premiums, many offer to cover the spouse/domestic partner as well as her/his plan, but will charge what is commonly known as a Spousal Clause, in which benefits are offered, however you are required to pay the entire premium for your spouses coverage.





Having said this, if your employer will not offer coverage to your spouse, I would consider finding an employer who will. The practice, in my humble opinion, is dispicable.
Reply:That varies depending on what state you live in. Most states will let your spouse be added, but the employer can require you to pay 100% of the additional premium, IF his current plan also insures spouses.


No comments:

Post a Comment

 
vc .net