Health Insurance...can This Be Legal?

What is the name of your state? NEW JERSEY

My husband works for a large company and in order for me to be covered under his insurance plan as I have been for last 3 yrs in his renewal packet comes a note from his employer that states that I must enroll in healthcare coverage if it is available at my place of business (which is a very small company and although there is a plan it is very expensive $45 a week for single) for myself and then they will reduce his weekly rate by $5.00 a week which is nothing.

If I do not enroll in benefits coverage at my place of work they will drop me from the plan. We are struggling...living paycheck to paycheck.. we cannot afford to pay for healthcoverage for me and then he for family coverage (we have 2 children).

Can an employer force us to do this? EIther way it looks like I won't be covered because I cannot afford to pay at my job and his job says if I don't they will drop me.

HELP!!

Can an employer force us to do this? Yes. Your husband's employer has elected to put a "spousal carve-out" condition in their health plan, which is becoming increasingly common. The particulars are exactly as you understand - if an employee has a spouse working elsewhere who is eligible for group health benefits at their place of employment, he or she is not eligible for coverage through the spouse.

Your husband's employer isn't doing this just for the heck of it. This is one of a number of plan changes many, many employers are electing to implement due to staggering increases in their group health premiums year after year.

Except in Hawaii, there is no requirement that an employer provide health insurance benefits at all. If they choose to offer it only to employees and not dependents, or only to dependents that have no access to other insurance, they legally may.

OK..thank you for your answers.

Does that mean that his company is able to get a better overall rate by making this a provision?

I am asking because after speaking to my VP about this I think I may have put a light bulb in his head (for cost savings...next year) about perhaps adding same to our health policy (although that would make many unhappy here).

Just a comment: I find this totally unfair for those like us who are struggling because it is very possible that many, including myself, may be forced not to have coverage at all.

Does that mean that his company is able to get a better overall rate by making this a provision? Sort of. It probably means that the huge premium increase the employer was just presented with can reduce it by 1 - 2% by including a spousal carve-out clause.

I find this totally unfair for those like us who are struggling because it is very possible that many, including myself, may be forced not to have coverage at all. I understand why you feel that way but many employers are seeing annual premium increases of 20 - 30% (or more) with no end in sight. Some employers are finding they're having to drop offering insurance coverage completely (particularly smaller employers) because they can no longer afford to offer it and the insurance companies won't underwrite the coverage if the employer doesn't pick up a large portion of the premium.

I Feel Your Pain

Although my husband's company (also a large well-known corporation - one of the Detroit "Big Three") doesn't refuse to cover me even though I have the availability of insurance at my employer, they do charge $30 per week extra for my spousal coverage than they would if I were a stay-at-home Mom with no other means of coverage.

It stinks, sure, but it is legal, and at least you have access to insurance. I know you are living, as you put it, "paycheck to paycheck," but if you look seriously at your budget, you'll probably be able to find many places where you could cut back and find $40.00 a week - less fast food? Less eating out? Brown bag lunch instead of eating out? Cancel the cable? WalMart instead of a department store? Stop smoking? I dunno...you have to search for it, but it's probably there somewhere.

In the meantime, I do NOT recommend you forego insurance altogether. Trust me, one bad illness will cost you MUCH MORE than the insurance.

Seems that going to work someplace at comparable pay that DOESN'T offer insurance, so you can get hubby's spousal coverage without also buying your own employer's coverage may be the only financially sound approach.

SuzieWahoozie said:

It stinks, sure, but it is legal, and at least you have access to insurance. I know you are living, as you put it, "paycheck to paycheck," but if you look seriously at your budget, you'll probably be able to find many places where you could cut back and find $40.00 a week - less fast food? Less eating out? Brown bag lunch instead of eating out? Cancel the cable? WalMart instead of a department store? Stop smoking? I dunno...you have to search for it, but it's probably there somewhere.

In the meantime, I do NOT recommend you forego insurance altogether. Trust me, one bad illness will cost you MUCH MORE than the insurance.

Click to expand...

Honestly, I have no choice and will have to cut cable and forget about any take out which we only do once every 2 weeks. I hate insurance companies...especially since the care and getting things approved is stressful. Still fighting to get some diagnostic tests for my daughter with Aetna and the child is in pain - - its in appeal. Sorry..just very frustrated.

nextwife said:

Seems that going to work someplace at comparable pay that DOESN'T offer insurance, so you can get hubby's spousal coverage without also buying your own employer's coverage may be the only financially sound approach.

Click to expand...

In a perfect world..or semi-perfect. Finding a job period for a decent pay in my field is not easy to begin with... But it sounds like a logical choice if it was realistic.