Health insurance through employer question

[mobbdeep]

What is the name of your state? Texas

I've been without health insurance and I was interested in getting it through my employer but unsure how that works since open enrollment is next month with them. I've only had dental/vision through them since August 2023 and have been out of work since January 29th, 2024.

When I asked my workers comp adjuster, he told me I needed to ask the employer who's responsible for the premiums. I emailed my employer and their response was "We would need you to pay the premiums for while you have been out. You can either start to make those payments to us now or upon return."

Is this accurate? It sounds like they're saying they would bill me separately for the premiums. I'm curious because if I can't get it through them, I'm screwed as the Healthcare Marketplace says workers comp doesn't count as a source of income. I feel like my only option is to find another job which I'm not quite yet ready for.

 

[AlmostThere]

Can you please explain how you have an employer since at least August 2023, but have been out of work since Jan 29, 2024?

 

[mobbdeep]

Can you please explain how you have an employer since at least August 2023, but have been out of work since Jan 29, 2024?

I was hired at my job in August 2023, injured on January 29th 2024 and have been on workers compensation since. This category is workplace injuries/workers compensation after all. I went back and added "workers comp" in my original post in case anyone else gets confused.

 

[cbg]

It is accurate that you are responsible for the premiums. How you make the payments is between you and your employer; that is determined by policy, not law.

 

[mobbdeep]

It is accurate that you are responsible for the premiums. How you make the payments is between you and your employer; that is determined by policy, not law.

Thank you. I also read that Texas is one of the states that refused Medicaid Expansion which disqualifies me for that. Healthcare Marketplace denied me because they said workers comp doesn't count as income. SNAP denied me because I make $186/mo more than the federal poverty requirements for a single household which is $2,005 and my workers comp is $2,191/mo.

I guess my only options are to opt into health insurance with my employer and be in debt with them upon returning, find a non-ACA compliant insurance company and get a plan through them but pre-existing conditions won't be covered, go back to work or be without health insurance again.

 

[quincy]

Thank you. I also read that Texas is one of the states that refused Medicaid Expansion which disqualifies me for that. Healthcare Marketplace denied me because they said workers comp doesn't count as income. SNAP denied me because I make $186/mo more than the federal poverty requirements for a single household which is $2,005 and my workers comp is $2,191/mo.

I guess my only options are to opt into health insurance with my employer and be in debt with them upon returning, find a non-ACA compliant insurance company and get a plan through them but pre-existing conditions won't be covered, go back to work or be without health insurance again.

Those all sound like options for you to explore.

 

[BensonBingham]

It sounds like your employer is following a common practice by asking you to cover the premiums while you're out. Many employers require employees to pay premiums directly if they’re not receiving regular paychecks, especially when on workers' comp or other extended leaves. It’s worth double-checking the specifics of your employer's policy in writing to make sure everything is clear.