Know your options

Question

Asked: May 03, 2010

Can my employer contribute different amounts for individual coverage?

My employer is dropping the group health plan where they contribute 1/2 of the individuals premium. We will continue to be reimbursed for 1/2 of the individual employee's premium of whatever plan we can find. I am not able to get individual coverage due to current meds and condition. Plus that idea that young healthy employees will be getting less reimbursement than holder employees due to the basic differences in premiums and different plans. Does this become EOE problem?'

Categories: In Massachusetts > Group Health
Plan Types: In Insurance Regulations

Watch this Question | Email to a Friend

Answers

This is standard practice and not an EOE issue. Under most group health plans, like the one that you are losing, the premiums charged by the insurance company will vary from one employee to the next, based on age and gender. This is called “aged-banded” rating and is how 70% of all group health policies determine total premiums. The other option, called “composite rating” calculates the premium average and charges bills a flat and set amount per employee. However, this forces the younger and healthier employees to pay more than they normally would. So, either way, it would seem unfair to some employees. In regards to your personal insurability, you may be eligible for coverage under the AccessTN program. This is the high-risk health insurance pool for residents of Tennessee. To learn more, you can contact them at 866-CoverTN, or visit their website at covertn.gov - Tuesday, December 1, 2009 @ 10:55am

Source: 

Answered: May 03, 2010

 

Top Group Health Experts

RANK LEADER POINTS
1. Goquoteme 10
2. Insurancestore 10
View More