Do I have to offer the same plan to all employees?

[Guest citardm]

Do I have to make "family" health coverage available to all employees? If so, does the contribution amount need to be consistent?

[This message has been edited by citardm (edited 03-20-2000).]

[KIP KRAUS]

CITARDM:

I don't know what kind of medical plan you are offering employees, but if it is an insured plan, usually the insurer will not allow you to have a class of eligible employees that treats employees differently if they are similarly situated employees. For instance, if the eligible class is all full time employees, then you generally cannot keep some employees from enrolling in family coverage. However, there are plans that require married employees' spouses to be enrolled in the spouses medical plan in order to be enrolled in the employee's plan.

Unless you have some non-descriminatory reason for disallowing some employees family coverage, you could risk law suits. If your plan is covered by ERISA you can also run the risk of violating ERISA in your eligibility provisions.

What is your criteria for letting some have family coverage and others not to have family coverage?

[jeanine]

I see at least 3 major problems with what you are proposing. If your plan is an insured product plan, state law probably prohibits you from offering coverage to some and not others. (depends on your state). If you are self-funding the plan, you can't discriminate amongst similarly situated individuals, however you may be able to offer a plan to just salaried personnel as opposed to hourly. Third, federal law known as HIPAA forbids you to require enrollees to pay a different contribution based on any health related status. Many states have similar laws which would apply if the plan was insurance. If you are determined to apply these rules you have suggested, I suggest you consult an attorney who is familar with health benefits law.

[Guest Matt Tuttle]

You may be able to start a voluntary plan that allows you to contribute an amount you choose to employee accounts, they can put in some of there own money as well (after tax), they can then choose the benefits they want to use the money for. You could put your whole medical plan in there or just strip it down to the bare bones and use the employee accounts to let employees who want the extra coverage to buy it themselves.

Matt Tuttle

203-609-9077