Medical Waiver Requirements?

[Guest Matt J]

Are they are regulations out there that limit an Employer's policy of Waiving coverage? I do not think there are, but cannot find one way or the other.

The employer currently does not have an employee contribution to their self-insured PPO plan and their waive option can only be taken upon proof of other group coverage. For 2004, they want to place an employee contribution (pre-tax) to the self-insured PPO plan and leave the Waiver policy as is requiring proof of other group coverage.

I have only seen a waiver with proof of other coverage, group or individual in other plans. Their goal is to keep as many young, healthy workers on the plan to help offset the "sicker" members and ones who cannot get coverage elsewhere. I know this logic is not sound, but ...

What are your thoughts? I am fairly certain they can do what they want with their Waive policy requirements, but cannot find any documentation either way.

[mroberts]

We just covered this topic last week. There's a thread under the Health Plan subject. If you are only requiring the employees to pay for a modest part of the health insurance premiums, there's not that many people who are going to decline coverage if they do not have coverage elsewhere. I would recommend strong communication about why this change needs to be done and what it means to not have any medical insurance.