Can An Employer Only Offer Coverage to Some Employees?
Ads by +HealthNetwork
I have only 20 employees. Can I buy Health Insurance for only 1 employee?
How do I find out what the rates are for a health insurance policy, and what coverage the policy offers?
Larry
I work for an employer that provides two separate medical benefit premiums for workers. If you are hired prior to 1/1/2019 you pay a lower premium, if hired after a higher premium. If the employer allows some hired after 1/1/2019, the ability to enroll in the lower premium, but not others, has the employer violated any law? If yes, which?
Mary Marianetti
Can an employer with less than 15 people offer benefits to everyone but me. I am the oldest employee (60 years old).
Everyone else is under 50 and get all benefits as soon as they walk in the door.
When I applied to ad it stated benefits for my position. The person I replace had benefits. They keep saying the insurance is dragging their feet, which is untrue, because I have signed for nothing and haven’t been given a benefits package.
Is this legal???
ObamaCareFacts.com
If an employer offers health insurance to one full time employee, then they have to offer it to all generally speaking. The same goes for part-time. This is answered above (and I also provide some extra details below). Thus, to your question, they should not be withholding coverage from you alone if you are all the same type of full-time employee.
I’m not sure if what they are doing is illegal, since they haven’t exactly refused to offer coverage, but it doesn’t sound right.
You can talk to them to get clarity, and you can also contact the department of labor if needed.
Please note there are a few extra rules worth considering, I’ll copy and paste some text below to clarify some key rules:
If an employer has under 50 FTE, then they don’t have to offer insurance to all full-time employees or pay a fee. That is in terms of the employer mandate.
With that said, employers are flexible in terms of which groups they offer healthcare to and can offer it to only specific groups of employees (such as senior level positions only or only full-time employees). The rule however is that if one person in a bona-fide group is offered coverage, then everyone in the group must be offered coverage.
Check this link out for details: https://www.nolo.com/legal-encyclopedia/can-employers-offer-health-insurance-only-to-certain-employees.html
Jason
I work for a city that has more than 50 full time employees. We have 5-7 part time employees that work anywhere from 32-39.5 hours a week. My employer should have to offer insurance since we work over 29 hours correct? Where can I find out more about this?
ObamaCareFacts.com
Yes, it is dependent on measurement periods, but the short answer is yes. https://obamacarefacts.com/questions/initial-measurement-period-start-date/
Chuck Bergstrom
Can an employer refuse to give you health insurance until you’re 21 even if you’re full time
ObamaCareFacts.com
I don’t think it has anything to do with age. I don’t recall age being a criteria for what is known as “the employer mandate.”
donna
We have 2 offices one in pa and one in nj. They offer 100 percent benefits to there employees and spouse and children. I havent needed because i was under my husbands insurance. My husband is leaving his job and I need health insurance for both. There answer was I can have it with a salary decreased. how can that be.
donna
forgot to mention I am the only nj employee
ObamaCareFacts.com
There are strange rules for employers who offer health benefits, essentially they can adjust your pay for taking/not taking health benefits. I don’t fully understand all the rules, I need to do a page on them. So you would want to perhaps ask them what specific rule is in play or do some research on DOL guidelines.
It is a somewhat complex topic as rules tend to be buried in different regulations.
Making a note to myself to research this more. Any clarifying comments are welcome!
NYer
Can an employer offer an employer plan to all full-time employees, but pay 100% of the premium for employees with tenure of 2 years or more, and only, say, 25% of the premium for employees with less than one year of tenure, and 50% for those between 1-2 years.
ObamaCareFacts.com
I’m not sure, I would have to research this. I’ll leave the question here for others to answer.
Saad Ghazipura
We have 2-3 Full Time employees and about 40 part time employees. Our weekly hours total is less than the 50 FTE (1500 hours per week) so we are not mandated to offer health insurance. However we are trying to see if we can offer insurance to our full time managers as an incentive. Would it be legal to offer insurance to only some of our full time employees if we are not mandated?
Nick
We have 57 FTE employees but only 27 FT employees. 10 of the 27 FT employees are management. Can I offer insurance to only those management employees? Will the first 30 exemption cover me from getting fined on the remaining 17 employees that I do not offer insurance to? In other words can I choose which of the FT employees I want to offer insurance to and use the first 30 exemption to avoid being fined on those that are not offered coverage?
ObamaCareFacts.com
I would have to re-read the fine print, but I think the exemption of the first 30 only works if you are paying the flat per-worker fee.
If an employer owes the fee because they didn’t cover workers, it’s a flat $2,000 per full-time employee (excluding first 30 employees).
The rule that applies here is that coverage must be offered to reasonably all (which is 95% of eligible workers).
In short, no, there is no good way for you not to offer coverage to all employees. I have to say, I don’t always agree with the implications of this. I think in a medium size business like this it is very reasonable to only offer coverage to higher paying positions. Its a rule that is meant for the Wallmart’s of the world. In my opinion this hurts most the lower-wage workers who are now going to be stuck with an employer plan which can on arrogate be more expensive than a subsidized marketplace plan.
But that is me commiserating, as for the practicality of the issue, you should either drop below the 50 FTE mark or offer coverage to full-timers, or do the not as fun cut back hours of non-management full-time workers in favor of more part-time work.
Amanda Phillips
Where I work we have 10-15 employees and only one is offered health care insurance and one is offered a RA benefit. Is this really possible? Can my employer really only offer this to only one employee when there is at least 7 full time workers?
ObamaCareFacts.com
A small business who doesn’t have to comply with the mandate (50 or more full-time equivalents), doesn’t have to comply with the mandate. So the answer here I think is yes, they can. If anything it would affect them in terms of tax credits… as they should be providing a group plan as a business unless they are utilizing a workaround. Remember, you can still use the marketplace if you aren’t offered coverage.
Miss
I work for a school district but because I’m hourly they stated I don’t qualify for benefits I work 37.5 hours a week..
ObamaCareFacts.com
While there are special rules for some employee types, like adjunct teachers for example, I don’t think that you being hourly negates the requirement for them to offer you health benefits if you are working 30+ hours on average.
There are things to consider, for example if they are full-time and how long you have been working full-time, and you should brush up on the rules to make sure it isn’t something else keeping them from offering you coverage.
However, if it is that you have met the requirements, I’m pretty sure the fact that you are hourly and not salary has nothing to do with it.
In other words, that is my insight, but you’ll need to do your own research. You might try to clarify again with the school to see if you understand their position correctly. Good luck.
For more info, see: https://obamacarefacts.com/obamacare-employer-mandate/