Both Spouses Have Employer Coverage, What are the Rules?
My husband and I both have insurance available through our employers. His employer is telling him that because of Obamacare, he is unable to sign up for insurance through his work if we are already signed up through my work. Is that right? I have also heard about a possible penalty for having double coverage?
An employer has to offer coverage to employees based on how many full-time workers they have, nothing else. If one spouse has employer coverage it doesn't effect whether the other spouse has to be offered coverage. The family is free to choose either employer plan, although they should choose the best option for them.
Having double coverage doesn't typically make any sense, but there is no penalty for it.
United Health Group is now saying that an employee has to pay a penalty of 150.00 a month if your spouse chooses not to use their own health plan. Is this legal?
Thank you for the comment. Some PPACA related things are easy to grasp and explain (for better or worse). This isn’t one of them.
It seems this is a somewhat common practice (and assumably legal). http://www.nextavenue.org/employers-penalizing-spouses-health-insurance/
This will require more research on our part. Anyone else with insight please comment below.
I am required to get insurance through my job if offered. I was told if it is not offered, they could offer insurance to me. So, if I’m not working, I can be covered. Is This legal?
Hi! My wife was denied health insurance coverage from her employer (church based with less than 50 employees) because they said she had previous spouse coverage under my employer’s insurance? Is that legal? Her employer said she needs to go back to my employer’s health insurance. What can we do?
if we both have our own ins. do i still have to carry her on mine?
I am the 100% stock owner of my corporation and my husband is an employee and we have a grandfathered small group health plan. Due to the new rules will we no longer be eligible for small group coverage even though my husband does not own any stock in the corporation and is truly a working employee?
I think it is only non-employee owners who don’t qualify for the group plan. But perhaps I am missing a specific rule.
My wife and I separated two years ago. My employer said I have to keep her on my insurance even though she works full time and has her own insurance.
An employer doesn’t have to provide coverage to a spouse, so I don’t see why they would force you to carry a policy for her? We would have to assume the employer offers both single and family plans and not just family plans. Only dependents HAVE to be offered coverage. I might be missing something, but this strikes me is odd based on what I know.
My husband is an Union worker through the IBEW and his insurance plan is an automatic family plan with a $500 deductible per person. He cannot opt me out of his plan, it is part of his pay package. But the IBEW gave us his new packet of coverage yesterday and it says since I have a full time job, I have to carry insurance on myself as well as long as it’s under $250 a month for me. But has a higher deductible of $2,700 and I make half the money an hour my husband does. This is just throwing away our money. Paying for dual insurance? How is it legal they MAKE me do that??? I think its fraud on their part!! Obamacare was to help us not hurt us, the IBEW said it’s Obama care’s law.
I’m going through it also, I feel like my heads to explode with anger!!!!!
I have been dealing with this also. My husband is also ibew. Do you lie to the insurance company or waste $1000’s a year? I’m opting out of my work insurance this year now that Obama is no longer going to be in office.
Just so that you understand, despite Obama leaving office and the Republican’s plan to repeal Obamacare, until that actually happens it is the law. Even if the Republican’s do repeal the law, it likely wouldn’t go into affect this year. If you chose to opt out and do not have minimal essential coverage before the law actually changes, you will probably end up owning the fee.
The same thing happened to me. The “affordable” care act cost my family a fortune. My husband can carry himself and our children and I got kicked off of his plan because I work. I make barely over minimum wage and we now have to pay two premiums and meet two deductibles and naturally my deductible is outrageous.
Prior to the Affordable Care Act employers weren’t required to offer dependent coverage (or coverage for the employee for that matter). Just FYI, the Affordable Care Act requires your husband employer to offer him and his dependents. The interpretation of that provision in practice appears to exclude the spouse’s and this is true even if you don’t have another employer offering you coverage. It’s definitely a loophole that needs to be addressed. The fact that your husband’s employer offered you coverage prior to you having another option is them actually going above the requirements of the Employer Mandate, but there is also no rule in the Affordable Care Act that requires them to drop you from your husband’s plan just because you now have an employer offering you coverage. Both of those decisions were the choice of his employer.
my company is not allowing me to cover my husband on my insurance plan if his company offers him an employer-sponsored insurance? can they do that? His company’s plan is only covers 50% of the cost.
I am experiencing the same – can they do that?
An employer can’t require that a spouse be covered as far as I understand the rules. They have to offer coverage to the employee, can offer to spouse, must to child dependents… but the employee can’t opt-out of any coverage, for either their dependents and spouse, or themselves.
You would want to double check this sort of thing, but here are the basic rules for employers on IRS.Gov. I don’t see anything about a mandate for an employee’s spouse to accept coverage, do you? https://www.irs.gov/affordable-care-act/employers/employer-shared-responsibility-provisions
My husband and both work and we paid for the family plain. I do not take my companies insurance. My Husband company is now stating if you spouse is employed they must take their employers insurance. Is it legal for his company to do this?
we would end up paying more in premiums and deductible If I had to take my employers insurance.
I have heard the same nonsense, did anyone tell you if this is true or not? i cannot find the right place or section to confirm this.
This is not true!
An employer does not need to cover a spouse under their employee coverage if that spouse is eligible under her own employer. example: Husband has family covered under his employers insurance. The spouse gets a job and can be covered under her employers insurance. Husband employer stated she can no longer be covered under his. Your last sentence state the ‘family is free to choose either employer plan’ not true. Happened to us and I called the Federal Labor commission (Chicago) and they confirmed that they can do this.
Then why are employers threatening to prosecute and fire employees who keep their spouse on their plans even IF the spouse has employer coverage available? they threaten (in writing) to fire you, fine you, and loss of Cobra benefits, what the hell is going on here?????
LET FAMILIES DECIDE WHAT PLAN THEY WANT TO BE ON!!
If an employer is doing that you need to report them to your states insurance commissioner. Large employers are required to offer coverage to employees and their dependents and those employees and their dependents are not eligible for cost assistance for marketplace health insurance plans if the employer offers an “affordable” plan. However, no one is required to accept the employer insurance that is offered for themselves or their family members. The Individual Mandate simply requires people to have minimal essential coverage for their household, get an exemption, or pay a fee. As long as they offer coverage, the large employer is meeting their obligations to the Employer Mandate, and as long as you get minimal essential coverage for all household members from somewhere (Spouse’s employer coverage, outside the Marketplace, Medicare, Medicaid, or VA) you have met your obligations. Employers threatening employees over not accepting coverage is not legal and you should be able to get help from your State’s Insurance Commissioners Office if you need help educating your employer on that.
Can you confirm that? I need some sort of source here. My husband works for a small business that isn’t required to offer insurance but has now decided to. He has been covered by my employer for the past 3 years. Now, my employer tells me that because he has been offered insurance, he has to take his offered plan and I could keep him on as a secondary insurance. We don’t need 2 plans, and we definitely can’t afford to be insured separately! I thought he could waive his offered coverage (because it is definitely not affordable, but we likely make too much money to get any sort of help with this) and continue to be on my coverage. Please, someone help!
There was some confusion here. Generally, employees can waive their healthcare (even if it is technically affordable)… however, it seems that (ACA aside) “there is no law in general that requires the employer not to require an employee to take a health plan”. You can read about that here: http://work.chron.com/can-employer-force-group-health-insurance-3458.html
This is to say, although in most cases employee’s seem to be able to waive coverage, there could be instances where they can’t. Since we don’t have all the details, we can’t give a definitive answer. We will need to do more research and update this page. Let us know in the meantime if anyone has official sources to cite (DOL guidelines, legislation, etc).
Ummm….Nope. I was told if my Husband has employered offered health insurance and I add him to mine…I will be fined $250/mo. So we either pay fines or more in Deductible and OOP.
This is something that some employers do and is not anything required by the Affordable Care Act. There are no rules preventing employers from charging fees to employees who refuse their coverage as well as employers who refuse to offer spousal coverage. Both are pretty frustrating practices by employers, but it is in no way a standard practice or caused by the law.
what if BOTH spouses have SAME employer coverage, what are the rules? we work at the same company! Please outline the options. BCBSIL
I have union health insurance.that my employer pays in for me and my family. My wife my family and myself has been covered on the plan at no cost. They tell me she has to buy coverage through her employer ( which will cost her 350.00 a mouth ) can they drop her and make her buy coverage from her employer ?
I added my wife to my plane they accepted her and then dropped her because she has insurance through her work she got on mine because it was better and cheaper can my company not accept my wife is that legal
My wife’s job wants to penalize her for including me on her plan while my employer offers coverage. my employer’s plan cost 3 times the amount we pay through her job.
Are they allowed to do so?
I had initially assumed that this couldn’t possibly be the case. But then after research I couldn’t find any rule against it.
This Forbes article doesn’t seem to suggest it is against the rules in any way. I’ll keep looking, as I’d like a definitive answer myself.
My spouse & I both work for companies that offer medical plans. I am on my spouse’s plan and have declined my company’s plan. My spouse’s company stated he must pay the premium for me because I declined my companys plan.
My empoyer says they are still deducting health insurance cost out of my paycheck even if I’m entirely covered by my wife plan, That doesn’t sound right! Is that correct or do they owe me that money back?
They can actually do that oddly enough. You can talk to them and see if there is a way to opt-out of their plan. Employers basically get to set their own rules. You may be able to opt-out and pay a penalty. All that said, if you can’t opt-out or if you would have to pay as much regardless, it is worth keeping in mind that you can hold two plans and use whichever is more generous as the first payer.
My wife is on her company sponsored plan that she pays for out of her paycheck. She is also on my company sponsored family plan which I pay for out of my paycheck (so she has primary and secondary insurance situation here). I am on my family plan as well as our two children. My company is telling me that if my wife is offered an insurance plan and elects to participate in both, I will have to pay a ~$150 per month ($1800 per year) “penalty” for this whole year until my next open enrollment period where I can make changes. This is on top of the whole family premium I pay for the family PPO plan. This doesn’t seem right at all. Why am I being penalized for having her on two policies both of which are paid for out of our own checks every pay period? Seems absolutely absurd! Somebody please make it make sense!
Employer coverage has some head-scratching rules. This includes the fact that each employer can effectively make you take their coverage and thus people end up with double coverage. You can generally on paper say no, but yeah you can also incur a penalty. You can ask your employer to explain it better, but it sounds about right given what I know. I can’t however confirm this specific situation is 100% correct, as I just generally know the rules and am not an expert in employer health insurance rules.