REQUIRING employees to take insurance.

KathyA · April 2003

Can an employer REQUIRE each employee to participate in the employer-offered health care plan in order to maintain participation rates. Thank you.

LindaS · April 2003

Our plan is written so that EVERY employee must take AT LEAST single insurance. The only exception is if we have a husband and wife that both work for us and one carries either family or employee plus one. In addition, our company does NOT pay 100% of the premiums.

sonny · April 2003

Same as Linda. We do pay 100% for the employee, though.

Parabeagle · April 2003

It's my understanding that if the employer pays 100% of the premium, the carrier can mandate 100% participation of all eligible employees. The only time an employee can opt out in most cases is if they are responsible for even a small portion of the premium; then they can waive off.

legalgal · May 2003

I have worked in the insurance industry for 20+ years, specializing in employee benefits. I am also a Benefits Expert Witness for the Courts. The ONLY TIME an employer can REQUIRE AN EMPLOYEE to enroll in an employer sponsored health insurance plan is if the employer has chosen to pay 100% of the employees' premiums. Although, even then, it is not an employer requirement for all eligible employees to enroll in the group Plan -- it is the Insurer's requirement. All group health policies have participation requirements that are an important part of the contractual agreement between the Policyholder (employer) and the Insurer. Participation requirement protect the Insurer against adverse selection, i.e., only the employees who need the insurance because they are "sick" will enroll in the Plan.

Moreover, all Insurers have a minimum premium contribution requirement that the employer must agree to provide. The employer premium contribution is also part of the contractual agreement between the Policyholder and the Insurer. Again, this requirement is to protect the Insurer against adverse selection. All Insurers knows that unless the employer is paying a major portion of the employee's premium, the only employees who will enroll in the Plan are the employees who "need" the insurance -- an adverse selection.

Typically, the minimum amount that the employer must contribute towards the employees' premium is somewhere around 75% -- although, with the rising costs of health isurance premiums nowadays, some of the Insurers have dropped that contribution level to a slightly lower level.

I hope that answers your question.

REQUIRING employees to take insurance.

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