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  1. #1
    Join Date
    Nov 2011
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    3

    Default Requiring Spouse to Use Employer's Insurance

    My question involves insurance law for the state of: Minnesota

    My wife has carried our health insurance for years. Recently, her company announced a requirement that spouses must use health insurance policies offered by their employers, except under certain circumstances (employee must pay more than 50% of premium, etc.) I understand they are trying to get rid of a dependent policyholder, but the policies are not equivalent (one is a large deductible, one is a more traditional policy). Is it legal for them to force me to be dropped from my spouse's insurance? Better question: Has is been legally tested?

  2. #2
    Join Date
    Jun 2006
    Location
    Massachusetts
    Posts
    24,521

    Default Re: Requiring Spouse to Use Employer's Insurance

    yes and yes. There is nothing illegal about making dependent coverage conditional. This is becoming more and more common.

    One thing to keep in mind is that at least at the current time, only two states require an employer to offer health insurance at all (neither of those states being Minnesota) even to their employees, let alone a requirement that they offer coverage to dependents.

  3. #3
    Join Date
    Nov 2011
    Posts
    3

    Default Re: Requiring Spouse to Use Employer's Insurance

    Thanks for the response cbg. I understand that the state law doesn't require insurance. The fact is, this company does provide it and the spouse is eligible until the company artibitrarily creates conditions that eliminate people from eligibility. My new employer pays 50% of the premiums on my health insurance, but we will pay $2,500 a year more in premiums because I am forced to make this change. What if I convince my current employer to pay $1 less than 50% of my premiums, making me eligible for my current insurance (based on their own criteria)? Your response indicates that this practice has been tested legally. Do you know of a precedent?

  4. #4
    Join Date
    Jun 2006
    Location
    Massachusetts
    Posts
    24,521

    Default Re: Requiring Spouse to Use Employer's Insurance

    You are not going to convince your employer to change his paying or billing practices so that you can avoid changing insurance plans. What you are suggesting is called fraud, and it is frowned on in many circles.

    The legal test is in the fact that the law permits an employer to change their eligibilty practices as long as they make the appropriate changes to the plan documents and do not discriminate based on a factor prohibited by law. There does not have to be a court test to allow it. There is already black letter law allowing it.

  5. #5
    Join Date
    Nov 2011
    Posts
    3

    Default Re: Requiring Spouse to Use Employer's Insurance

    First of all, I am not suggesting fraud. If company 1 can make rules forcing another company to absorb their costs, it wouldn't be fraud for company 2 to adjust their rules to prevent them from doing so "as long as they make the appropriate changes to the plan documents and do not discriminate based on a factor prohibited by law," as you so aptly point out. My point in all of this is that company 1 is simply passing its costs to someone else, which, while perhaps becoming commonplace, is disingenuous and I hope someone figures out a way to circumvent it - legally, of course.

  6. #6
    Join Date
    Jun 2006
    Location
    Massachusetts
    Posts
    24,521

    Default Re: Requiring Spouse to Use Employer's Insurance

    It would be fraud for an employer to conspire with you to charge you $1 less than 50% of your premiums so as to affect your eligibility for another plan. And he has no incentive to create such a nightmare for himself as the logistics of making such a change for everyone else would exist.

    You're still not getting the fact that company #1 is not "passing their costs onto someone else". The costs do not belong to them. There is nothing illegal, immoral, or unethical about stating that they will only cover those spouses who have no access to coverage through their own employers which, looked at the other way around, is essentially what they are doing. They have no legal obligation whatsoever to cover ANY spouses or dependents - at least not yet. They don't even have a legal obligation - yet- to cover employees. If they are willing to provide coverage to those spouses who have no access to other coverage but not to those who do, they are still doing more, not less, than the law requires.

    I'm sorry you are being inconvenienced by their decision but the employer is doing nothing wrong.

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