Our company apex limited is “forcing” us to take there insurance ..It has no wellness for mammogram or OBGYN pap testing is this legal?


Answer

If an employer offers grandfathered or large group coverage that doesn't offer all benefits of the ACA it may still count as minimum essential coverage and fulfill the requirements of the employer mandate.

Large group plans don't have to offer ten essential benefits (which include some women's health services) and grandfathered plans have to offer even less. As a rule of thumb all coverage sold after 2014 will include all the benefits of ObamaCare, but plans established before the ACA became law have loopholes. Typically as a trade-off this sub-par coverage is typically cheaper than newer coverage, but not always.

If your employer is exempt from the mandate or is offering a grandfathered plan it may not offer all the benefits, rights, and protections of the Affordable Care Act, but may still count as minimum essential coverage and prevent you from getting cost assistance on the health insurance marketplace.

This fact sheet from CIGNA helps explain it a little better. You can learn more about what benefits are included and what are restricted on grandfathered plans here.

Rate and Comment on the Answer

Your email address will not be published. Required fields are marked *

1 2 3 4 5

This site uses Akismet to reduce spam. Learn how your comment data is processed.