Medical Insurance

Does an employer in NY have to contribute equally by class of employee to health insurance premium?

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2015-07-15 21:29:35
2015-07-15 21:29:35

It appears the Federal Law would require them to - "Simlarly Situated Individuals"

The group of covered employees, their spouses or dependent children who are covered under a group health plan maintained by the employer or employee organization. This group is receiving their benefits under the group plan and not through COBRA continuation coverage. They are most similarly situated to the circumstances of the qualified beneficiary immediately before the qualifying event.

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See also the employer group application -

check the employer contribution sections

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No, an employer cannot suspend health coverage if the employee pays part of premium. as per Law.In case where the employer pays the entire premium, he can suspend health coverage on one pretext or other.But when the premium is equally shared by both the employer and employee, it would be a contractual violation and the employee can sue against his employer for remedy.

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The required Social security and medicare taxes. Also known as the FICA taxes.

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There are a host of variables that come into play with your question. For example, specific employment contract clauses, hire dates, etc. Call your insurance agent. They will be able to give you a detailed response.

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Generally NO. In CA it's in violation of AB 1672 - Insurance Code 10700 If you're the ONLY employee that might work. If there is more employees, individual plans have the disadvantage of being medically underwritten and there is some employee now or in the future who won't be eligible. In a group plan, ALL employees are covered regardless of medical conditions. Also all "similarly situated individuals" must be treated equally. It is possible if the employer is using a Health Reimbursement Arrangement (Section 105 Plan) for all employees. As stated above, the employer can not discriminate and must treat all employees equally. Generally what they can not do is have both an employer sponsored insurance plan for some employees and an HRA plan to reimburse some employees with their own individual plan.

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No No, these types of plans can not discriminate. The plan can have specific exclusions but they must be applied equally for all employees.

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