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Asked: Apr 28, 2010

Can I be enrolled under two group plan's at the same time?

My employer has a health insurance group plan for 10 members of staff in our store, which I chose to opt out of. The other 9 employees are all in the plan. I am on my husbands health insurance plan through his job and we have an ecellent plan, though quite epensive. I have asked my boss if she would be willing to come to an agreement to compensate me (even for a percentage of the $7,000 per year I save her by not using her plan) which she saves. She flatly refused. I therefore do not wish to save her $7,000 a year. My question is, if I go ahead and ask her to put me on the company health insurance plan anyway, (even though I will never, ever use it) will this have any affect on my current plan with my husbands company and is it ok (or legal) to have two plans ? Thans

Categories: In Pennsylvania

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Answers

What may seem like an unreasonable decision from your employer is actually common practice. The employer has no obligation to compensate you for the savings they realize when you chose not to enroll in the health insurance coverage they are making available to all employees. You can certainly elect to enroll in the group health plan if you so desire, but you will need to wait until the annual open enrollment period to do so. Employees that decline enrollment when first offered can only be added to the plan for a 30 day period, once per year. You will need to check with your employer for this date, as it is the anniversary date of the establishment of the group health plan. The other thing you may wish to verify is the coordination of benefit laws in the State of New York. Your current insurance company can tell you how this will work in your case. If you have two insurance plans, one of them will be the primary insurer, and the other will be the secondary. All medical claims will first be submitted to your primary insurance carrier. If the secondary insurer provides more comprehensive benefits, they will be responsible for the difference. For instance, if your primary insurance company pays 80% of a claim, and your secondary insurer pays 90% of a claim - the primary will pay 80% and the secondary will only pay the 10% difference. Typically, your employer's coverage will act as primary and your spouse's group health plan will act as secondary. These rules may be different in NY, so it is best to verify this with your current insurance company before making the decision to join your employer's plan. - Friday, December 18, 2009 @ 11:35 am

Answered: Apr 30, 2010

 

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