Can I Waive Employer Insurance if I Have Coverage?
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I am a veteran receiving VA health care. For the past two years I have been able to waive employers insurance because of my VA. I have been notified that I can no longer waive the insurance and will have to pay over $600.00 a month just for myself from my fringe which at this time goes into 401K. I have been told that I have no choice. I will lose my monthly contribution to my 401K. If I am no longer covered by the VA under Obamacare I would like to enroll in a more affordable plan and continue to contribute to my 401K.
* Can my employer force me to accept their insurance? The company is a military contractor in TX.
* Who can I contact to help me with this issue?
Alicia GOmez
I believe the person asking the question is referencing to the Health and Welfare Fringe, provided under the Service Contract Act that is provided to employees for the purchase of employee benefits.
Since H&W Fringe for some employees can be paid as Cash in lieu or as an excess deferred to 401k accounts, wouldn’t the allowance of directed above violated the secondary payer rule, since the H&W fringe can constitute as an incentive to waive and make federal insurance the primary payer?
ObamaCareFacts.com
I have to double-check the answer here but appreciate your insight. Thank you.
Richard
I currently work for a contractor and they tell me I am FORCED to take their insurance that I neither want nor need. Married employees who have coverage through their husbands get the $4.21 fringe benefit wage as cash. I’m single so I get screwed. I do the same exact job but get $673 less a month.
ObamaCareFacts.com
For some reason in the United States your employer can force you to take coverage (or penalize you I think if you don’t). Nothing to do with the Affordable Care Act per say, just an odd rule that I can’t make sense out of. Here are some resources on this:
https://work.chron.com/can-employer-force-group-health-insurance-3458.html
https://www.insure.com/health-insurance-faq/forced-to-take-employer-health-plan.html
An employer doesn’t have to do this, but essentially they get a tax break for forcing you to have coverage you don’t want.
One of many reasons on might argue single payer would be an improvement to the current system despite it requiring some form of tax.
Regina Matthews
You are obviously a Service Contract Act employee and that is where this question is coming from. I would suggest you read the SCA to help you understand why your fringe benefit is now going towards company health insurance. In a nutshell, the employer gets to choose where they spend the fringe benefit. As long as it is a bono fide fringe benefit it is legal.
Suzanne
It appears that this question needs an updated OFFICIAL answer… Can I Waive Employer Health Insurance if I am covered currently under my husbands Employer Health Insurance. We are willing to pay the yearly fine to his employer so that I can remain on his insurance, because it is infinitively better, more comprehensive coverage than what I am being “offered” through my current employer. But, I am being told that I am “required to enroll”.
Erin
You are never required to take a specific insurance coverage, only to have minimal essential coverage. Employers are required to offer coverage to employees and their children, but many also offer this coverage to employees’ spouses. If you are offered employer coverage that meets the definition of “affordable” under the ACA, than you won’t be eligible for cost assistance on the marketplace.
So long as you have minimal essential coverage, you won’t owe the fee for not having coverage.
Olivia Addison
I too have the same issue. My contract says I have to take their insurance but I have Tricare prime due to my husband being active duty. I was on the insurance with my company before we got married but dropped it once I got Tricare. The companies insurance would not cover most of my medications and doctor visits were $90 co-pay every time.
Amber Banks
My current employer has always offered what is called a Wage Differential Option. As an employee, I was able to opt out of all benefits including PTO and health care coverage and in turn was able to be paid 15% more. I have been told that due to the ACA, this option will no longer be available. Can you shed some light on this please? I have have health care coverage through my husband’s employer as part of his family coverage plan. Thanks!
Contractor
Actually, I think the original answer is off the mark; if the benefit is employer-paid, then they absolutely can use is for mandatory health insurance.
If your company is a military contractor, it’s highly likely that they are using the Service Contract Act “health and welfare” benefit dollars as an employer contribution that covers the entire cost of an individual health care policy. You think of it as your fringe, but more accurately it is the employer’s benefit to spend on your health and welfare as the employer sees fit in accordance with the SCA and ACA.
It sounds like they they “sweep” the remaining amount of any employer contribution, post health ins. premium, into a retirement account, instead of paying it out as cash. This is the most conservative way of SCA H&W compliance, though there also are many contractors that pay the remainder out as “cash in lieu”. This also is compliant, but the IRS has signaled that it may do away with permitting this practice.
If my assessment of your scenario is accurate, then mandatory enrollment that is paid for by the employer is 100% legal and an increasingly common practice because it is fully SCA-compliant in the most conservative reading of that law and lowers everyone’s healthcare costs.
Scott
I am in a similar situation. Been looking for information to confirm my thoughts. Been employed by a contractor at a major city Airport. Our wages and benefits are supplemented by federal tax dollars. For the past 9.5 years we can either choose health care or 401. I have tricare, so I took the 401. New contract for 2016 for our employees with tricare, VA services and Medicare if we have to take health plan. Would like to locate in ACA in writing on this info. I am still eligible for tricare and va. You should still be eligible for va.
darrel forney
Should we be exempt since we are part of the va not Tricare and the Va is compliant with the aca. I had thought the Va exemption was still in effect. Please explain. Also its a government contractor with fringe benefits. They say that their medical would be too high per person and now forces everyone including Tricare and medicare to enroll. I feel since I am with the va I shouldn’t have to.