employee pays 100% of premium

[ajvarnado]

What is the name of your state?undefinedWhat is the name of your state? New Mexico. My husband's employer just announced and deducted 100% of our health insurance premium from my husband's most recent paycheck. the employer says the we can only keep the insurance if we pay the entire premium. this is quite a jump for us. the premium was $20, now it is $790 dollars a month. this requirement of total payment was placed on all the employees who use the health insurance. This is a small employer of less than 20 people.

the employer also says we cannot pay the premium directly to the insurance company or deduct it from our income taxes, because it is a pre-tax benefit. i am six months pregnant with a high risk pregnancy and my hubby is diabetic/ hypertensive and we would have a hard time getting insurance right now.

Does the employer have to pay any of the premium? Are we entitled to notice before a premium/contribution can be increased? what should i do, other than look for cheaper insurance?

 

[kathrynne]

Does the employer have to pay any of the premium? Are we entitled to notice before a premium/contribution can be increased? what should i do, other than look for cheaper insurance?

Nope. I dunno. Find a different job?

Have you never had a job that provided no health insurance, regardless of how many hours you worked? We do not have mandated health insurance in this country, regardless of Hilary's desires, so it's up to neither your employer nor the government to provide it. At least your employer provides a "group" of some size or other, which might lower your premiums from what they would be as individuals--especially since you are of "childbearing age" and your hubby has health problems.

People "shop" jobs for all sorts of reasons, and health insurance is one of them--but mind the pre-existing condition clauses!

 

[cbg]

While I cannot say that I've studied the law in all 50 states, I am not aware of any state that requires an employer to pick up a portion of the premium for health insurance. Except in Hawaii, they are not required to offer health insurance at all.

You MIGHT, if NM law specifically requires it be entitled to 30 days notice about changes. But few states have such requirements because frequently, an employer does not finish negotiating with the insurance carrier until just before the new rate kicks in. At least in my state, an employer of the size you describe probably only got 30 days notice of the new rate themselves, and lost some of that time trying to negotiate a better deal.

It would be a logistical nightmare for the insurance carrier for you to pay them directly. I've worked for an insurance carrier and trust me, if you want your insurance cancelled every other month because they can't identify what policy your check is supposed to be applied to (because it would be an individual check for a group policy) then by all means send the check to the insurer. The policy will be in your employer's name, not yours, regardless of who is paying for it; it would be next to impossible for the carrier to keep up with 20 individual checks all coming in at different times to be applied to one policy that is in a totally different name.

If it's a pre-tax benefit it's quite possible that you can't deduct it, but I wouldn't take your employer's word for it. Ask your tax advisor. I am not saying your employer is wrong, but it won't do any harm to check. Keep in mind though, that he has no incentive to lie to you about this; it doesn't affect him one way or the other whether you deduct this on your income tax or not. Why would he tell you that you can't, if you can? Doesn't hurt him any either way.

 

[somarco]

The employer has essentially changed the plan to a voluntary plan (by implementing 100% employee contributions). This assumes all employees are treated equally and the employer has not singled out individuals, or classes of individuals to be covered.

To my knowledge, your employer cannot require you to participate in a voluntary plan. They cannot make it a condition of employment. I suspect the NM DOL would have something to say about an employer REQUIRING employees to participate in a fully contributory plan.

What astounds me as much as anything is the jump from $20 to almost $800. This seems to indicate there are financial problems for the employer as much as anything.

With your pregnancy you really dont want to make any changes. Bite the bullet and cough up the money for the next 3 months. Sure beats going naked.

Ride this out and then weigh your options. Could be changing jobs is in the cards or dropping the employer plan and seeking individual coverage, most likely at a lower price.