Dropping off and back on to company plan

Background: I voluntarily dropped family health insurance coverage with my employer when our budget got tight a few years back. My wife covers herself and our daughters through her employer.  I’ve remained on my employer’s policy.

I now either want this coverage back or compensation for giving it up. Co-workers have family coverage partly paid for by the company. I only want same benefit as co-workers have.  They are essentially getting paid more for having their family on the plan.

Questions: Do I have the right to ask for it back (full family coverage)? Can I get compensation instead of the coverage if family is still covered by wife’s policy?  Can my employer enact a company rule or policy that if coverage is available through spouse they do not have to offer it? If they ask about her insurance can I tell them it is none of their business?

Working Every Angle

Dear Working Every Angle ,

Great questions and an ever-more common situation as people struggle to make ends meet.

First, yes, you can get back the family coverage you had before.  You would have to have a family status change in order to re-join your company’s plan, or you could re-join at the next open enrollment.  A family status change includes your wife’s group’s open enrollment, so when she is due to re-up her plan, you could apply to your company’s plan.

Getting the coverage back won’t be a problem.  Getting paid to not take it is another issue.  Companies can decide whether or not they “cash out” a person who skips their health plan.  If the company doesn’t already have this in place, you cannot cite any laws to force them to.

Your point is valid that co-workers who take the family coverage get more money from the company, since the company pays for part of the cost.  However, they do not have to make this fair by paying you to take your family elsewhere for its health plan.

As for turning you away because your wife can cover you, the company would not be able to do that.  They would be treating employees differently based upon their marital status.  I realize this seems similar to paying family men more (by subsidizing the cost of family coverage) than the single bucks (who get only single coverage).  But in the case of family coverage, the company is merely making the cost of family coverage lower.  It is not withholding or awarding coverage entirely.

You can make your argument to the company, raising these points.  And, who knows, they may be persuaded to your point of view.  Good luck!

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Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.