Primary and Secondary Health Insurance

[tcollins]

Hi everyone,

My mother's employer offers health insurance to their employees. My mother is also covered on my dad's health insurance through his employer. My mother's employer keeps telling her that having primary and secondary health insurance is illegal in Pennsylvania. Is there any truth to this? Is it illegal to have primary and secondary health insurance in Pennsylvania.

My opinion is that her employer just doesn't want to pay for her insurance but they have to if they offer it to all employees.

Thank you,

Tracy

[lealea1005]

Hi everyone,

My mother's employer offers health insurance to their employees. My mother is also covered on my dad's health insurance through his employer. My mother's employer keeps telling her that having primary and secondary health insurance is illegal in Pennsylvania. Is there any truth to this? Is it illegal to have primary and secondary health insurance in Pennsylvania.

My opinion is that her employer just doesn't want to pay for her insurance but they have to if they offer it to all employees.

Thank you,

Tracy

How many are employed by the company your Mother works for?

[tcollins]

I'm going to say there are probably between 20 and 75 employees. I'm not exactly sure.

Tracy

[lealea1005]

Hi Tracy,

If your mother is working full time, the insurance your mother would be elibile for through her employer would then be her primary insurance.

The policy held by your father would become her secondary insurance policy.

I don't know of any law that would prohibit her from carrying primary and secondary insurance.

[Betty3]

This is becoming common & it's legal. Many companies will not offer coverage to someone who already has it. In Pa. it's not even required that health ins. be offered to employees.

[tcollins]

Thank you.

I figured that there was no law but my mother was asking me to look it up online so that she could show her boss but I couldn't find anything. If anybody knows of anywhere that I can find this information, please let me know.

Thanks again,

Tracy

[cbg]

If you're looking for a law that expressly gives permission for someone to hold both primary and secondary insurance, you're not going to find it. The law specifies what MUST be done and what MUST NOT be done; it does not specify what MAY be done.

Since no law exists that says one cannot have two insurance policies, one can. However, there is also no law that says that someone cannot be deemed ineligible for employer-sponsored group insurance on the basis of the fact that they have other insurance elsewhere. It has to be expressly spelled out in the eligibility rules of the insurance policy, but it is not prohibited by law.

Another thing to consider is that it is rare indeed that a secondary policy will pick up all balances not paid by the primary carrier. Almost all of the time, the secondary carrier will only pick up anything over and above what they would have paid as primary (Example; if the bill is for $100 and the primary carrier pays $80, the secondary carrier will only pay the difference between $80 and what they would have paid if they were primary. If, had they been primary, they would have paid $90, they will as a secondary carrier pay $10. If they would only have paid $80 as primary, they will pay nothing as secondary. ONLY if they would have paid the bill in full had they been primary, will they pick up the entire $20 balance.)

Unless the secondary carrier is significantly better than the primary carrier, it is probably not cost effective to carry both coverages.

[tcollins]

Thanks for all the input. I don't know the rules that my mom's employers insurance has but for some reason, they are not allowed to deny one employee health insurance just because they have another insurance. The employee has to actually opt out of the insurance. I'm assuming that it has something to do with the insurance provider but I'm not exactly sure. Anyways, her employer has been pushing for my mom to drop the coverage that they offer because she is covered under my dad's. So I figured this was just another ploy to get her to drop the insurance at work

Thanks again, it is really appreciated.

Tracy