Spousal coordination of benefits

[Guest hdavie]

An employee cancels her health care plan during our open enrollment and enrolls with her husbands plan from another organization. Several months later the employee is notified by her spouses employer that she must go back to her own employers health care plan. The reason listed is that her employers plan requires less than 50% employee contribution. If she fails to take advantage of her employers plan she will receive only 20% coverage under her husbands plan.

Is it legal for the husbands employer, a state government agency, to only offer 20% coverage ?

Would the employee be able to re-enroll immediately with her employers plan under the family status change guidelines ?

[KIP KRAUS]

It is not uncommon for an employer (say employer"A")to require spouses of its employees to enroll in their employers health plan before even allowing the spouse to participate in employer "A's" plan. In fact, I believe it was J.C. Penny's who tested this requirement several years ago in court and won.

If the the employer wants to reduce benefits for those spouses that do not follow the plan rules, I don't know of any regulations that would prohibit that from happening as long as the provisions are administered equitably to male spouses and female spouses, which is what I think the J.C. Penny's case was related to.