Tuesday, April 26, 2011

can an employer deny health insurance for a spouse if they have insurance in california?

i have insurance and he is on mine, and he has insurance but it is too expensive for both of us. is there a particular law that says my employer cannot force me to use his or force him off mine?
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It is rare for an employer to cover insurance costs for both a employee and spouse without requesting a percentage of the cost during annual or subsequent life event enrollment. It is normally cheaper for each employee to obtain insurance from their employer individually rather than as an EE + spouse. For example, my Blue Cross insurance costs $35 per bi-monthly pay period and my husband's costs $75. If we chose just one policy for both of us, the monthly costs would rise to $230 (mine) $362 (his) which is a 10% increase over last year. They are both Blue Cross, but mine covers 90 physical therapy visits and his only 24, otherwise they are identical. Since I need lots of PT and mine was significantly cheaper, we chose to get policies this year from our individual employers. An employer could not deny group insurance to a spouse that had addtl coverage, any denial is up to the insurance company. Denial would typically happen if the enrollment card was signed late, a EOI (evidence of insurability) was needed and a medical problem precluded coverage. A company cannot force you to use his policy or take him off yours. The action of needing a marriage license seems rather offensive though. Are they having issues with imaginary spouses? If you have any questions call your HR or benefit specialist and the customer service line at each insurance company for clarification.
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