Exception to group coverage?

[Guest debr]

Can someone who opted out of group coverage purchase his own insurance coverage and still expect the company to pay 75% of his cost (or only up to what we would have paid if he stayed on our insurance) like we do for group coverage? If we allow for him, do we have to allow for all.

Thanks

[KIP KRAUS]

Absolutely not, unless the employer wants to offer an opt-out payment to those who don’t take the employer’s medical plan. In this case the opt-out payment is usually not as much money as the employer would pay if the employee were enrolled in its plan. Also it typically only applies to family coverage. I find it hard to believe that an employee can find better coverage on an individual basis unless he is enrolled in some other employer sponsored plan. In any event, he should have no expectation that the employer pay anything for his individual coverage. It’s strictly up to the employer expectations or not.