Health Benefits - New Policy on Spouses

Pay the $600. Fifty bucks a month is not worth making an issue of it.

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3. Should I just put she doesn't have health benefits available because there was a verbal agreement in place?

I am leaning towards option 3. There is no evidence requirement that I can find so I think the verbal agreement at least gives me something to stand on.

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That would be insurance fraud, and, if they find out -- THEY ALWAYS FIND OUT WHEN BIG $$$$$'s ARE INVOLVED -- that could be the basis for them to deny coverage.


Your wife's "verbal agreement" has NOTHING WHATSOEVER to do with your company. Your wife was able to negotiate a higher salary. Use that money to pay for her insurance. Why the hell should your company pay for her insurance if she's eligible with her own employer?

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sapo504

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My company just opened us up to annual enrollment and I was notified if my spouse has available health insurance benefits and chooses to stay on my plan I will have to pay a surchage/fee of $600/yr if I keep her on my insurance.

Couple other facts. When wife accepted the job she indicated she didn't need the benefits and its a small business so was used in her salary negotiation for more base pay. I do not believe it was ever put in writing, but it was agreed to verbally. Also, her insurance blows and is more expensive substantially - more than $600 - so going on her insurance is not an option even if her boss would allow it.

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She negotiated on a higher salary w/no healthcare and based it on your costs staying static. So add her to your policy, eat the $600. It all works out in the end.

Her basis for the higher salary was evidently a dynamic variable you both didn't consider being dynamic. Ya'll were wrong but greater tradgedies have occurred. You sound like you're wishing life was more fair.

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...and I was notified if my spouse has available health insurance benefits and chooses to stay on my plan....

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I think the answer here lies with your wife's company, and it may very well be "no". Seems your company is asking does your spouse (at this time) have available health insurance benefits? The fact that she had benefits available to her several years ago and whether they are available to her today are two different issues. Because it is open enrollment for your company, it doesn't necessarily mean that your wife's company will immediately offer the insurance benefits she turned down several years ago. I doubt that they would. If that is the case, then you shouldn't owe the $600 per year. If you would terminate employment at your company, then a "life's event" would have occured that would automatically make your wife eligible to be insured under her employer's health insurance but that hasn't happened.

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1. Is it legal to do this in Louisiana?

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Contact the Louisiana Department of Insurance. They can answer the legalities of the situation.

I would definitely get something in writing if her company will not allow her immediate coverage.

All of the above statements are subject to the new Health Act rules and regs which are constantly being updated (daily). The new Health Act could be the very reason your company is seeking new options insofar as covering spouses.

Several years ago, an employer with fewer than 50 employees terminated their (small employer) group insurance plan because the spouse of one of their employees became ill with lung cancer. The insurance agent then sold individual policies to all of the employees and spouses except for the employee who had a spouse with cancer. He was sold a policy. She was not. So I do feel it's better for employees to be covered under a large employer's plan....that may change, however, if the Health Act is not repealed.

The above is not to say I don't blame your employer to charge the extra $600 per year though, however, the legality of it is a good question to want answered!

This isn't relevant...but to include a spouse on our coverage, the premium for the spouse does not come out of my paycheck pre-tax for him. So we opted for him to have his own coverage which is pre-tax through his own employer.

I just had a large claim for my son who is on my insurance. After all was paid, the health insurance auditor contacted me asking about my husband's insurance coverage. If my son was also covered under his policy, then his policy should have paid because his birthday comes before mine in the calendar year. I told them my son was only covered under my policy, but they called and checked it out anyway.

You can bet the insurance companies hire people just to look for ways to get out of paying the claim. Don't risk it.