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Old 02-01-2013, 10:32 AM   #1
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Question Insurance Advice

I am 46 and I have always carried my own health insurance. I have seen the COBRA nightmares when people lose or leave a job and I never wanted to have that premium over my head. I am insured for parent & child and have a pretty low monthly premium.

I work at a small office of 5. Of our employees only one - the boss- is on our insurance. I have private insurance, one person is not eligible and the other two are on spouse or parent insurance.

My boss and his spouse have heavy medication bills and need the level of insurance offered by the office. However, with only one person on the plan the business doesn't meet the minimum to qualify for the insurance.

My boss' solution is to have me come on to the office plan, which means I would have to give up my personal insurance. If I don't it would mean that he and his spouse would lose their coverage. But, if I do, it means that if I lose or leave my job, at 46 or older I would have to re-qualify for health insurance at a much higher rate and my son would not be covered.

He has not made it a secret that he expects me to do this and although I need my job I hate to sacrifice my and my sons, long-term healthcare and financial security to save he and his spouse. They are not my responsibility.

One solution I suggested is that I take the office insurance as a secondary, but he says that would not work. I don't know what to do.

Please let me know if you have any ideas how I can deal with this.

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Old 02-01-2013, 10:54 AM   #2
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Are you using a broker for your own insurance? What about your boss? I would try talking to both sides, and see what they say. I don't know enough to say whether or not your boss is correct about you having to have that ins. as primary or if you still could maintain your own. But you'd also want to find out if he expects to pay 100% of the premiums, esp. if you are able to maintain your current insurance and still pay for it yourself.

The other question is how secure do you think your job is? I know there are no guarantees but if you've been there for a long time vs. being new, etc.

I have a lot of sympathy for you, it's horrible that we have to worry about this stuff. I have a minor pre-existing condition of migraines, not really that big a deal but I do take daily meds to prevent them. And at one point, between jobs, I looked into individual coverage and those would have been excluded. So I have always limited my job choices to larger companies with big group health plans.
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Old 02-01-2013, 10:56 AM   #3
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I would make him pay to add you on his insurance and keep paying for your own. I would also keep this to myself.
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Old 02-01-2013, 11:05 AM   #4
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I work in the sales & admin of canadian life/health insurance. i'm not entirely sure how the american system works, however, risk management is risk management and there are a lot of similarities in how canadian carriers do business. you mention some great points. whatever you do, do NOT surrender your personal contract as like you said, when you're older you will have to requalify for the coverage and heaven forbid you come down with any type of condition in that period as as the saying goes, once the house is burnt down you can't insure it after the fire. ...do carriers down there provide co-insurance? what is meant by this is that your plan covers a percentage to a certain maximum, say for example, 80% up to $10,000/year for meds with a $25 deductible. here in canada you could have your policy that has this and be covered under an employer's policy who would cover the remaing 20% and maybe even up to an additional maximum. this is very common with spouses as each will be covered under their employer and as dependents on the others plan making for virtually 100% coverage.

if this is not an option, get your employer to find a broker to shop the market to see if they can get better rates elsewhere. in canada, if insurance companies spend more than $0.70 for every dollar in premium they receive, they jack their rates the following year. ...these are profit companies.

hope this might help some? ...follow your gut on this one and whatever you do, don't get rid of your coverage and be sure to know what kind of coverage your policy will provide you when you become 65 or older. here, we have a lot of policies that drop clients and then when they need their coverage the most, they are uninsured. yes, we have 'free' healthcare, but that's only for procedures/drugs administered while in a hospital. everything else we have to pay for. ...either through insurance premiums our out of our own pocket.
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Old 02-01-2013, 11:14 AM   #5
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tHang unto your insurance. If he can provide insurance for you to help him out then he should pay for it and as nomorejelly beans says keep the insurance but also keep it a secret that you are keeping it.
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Old 02-01-2013, 11:22 AM   #6
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I'm so sorry you are having to deal with this decision. Health insurance is scary, the job market is scary, everything is scary.

I got a lump in my throat when I read that he pretty much expects you to join his plan, that is no way to have to make a decision.

The only thing that came to my mind was maybe having your attorney draft some type of agreement like they do for divorces that he'd pay your health insurance premiums for 5 years (or whatever you agree to) if you separate from the company due to a layoff, company closure, etc.

I hope something gets resolved sooner than later; you don't want this decision hanging over your head too long. It's too stressful.
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Old 02-01-2013, 12:06 PM   #7
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Thank you all for your advice. Having more options to consider makes me feel better.

Are you using a broker for your own insurance?
I did not use a broker for my insurance. The broker for the job insurance says that I would need to be in 100% for the business to maintain coverage.

The other question is how secure do you think your job is? I would like to think my job is secure. I have worked here for 5 years but I have known my boss for several years. We worked together at another business and he recruited me when he took over operations here. To be honest, this situation makes me realize that no matter the history or friendship he would hang me out to dry.

I have always limited my job choices to larger companies with big group health plans. I know, healthcare decisions impact so many areas of our lives.

make him pay to add you on his insurance and keep paying for your own. It seems you all feel this is the best course of action. I like the idea and I will have to put on my negotiation hat for this. Since it is a small business and the Board of Directors will have to approve the pay out I will have to dig in my heels. If I can swing it I will definitely keep my mouth shut.

nads84 I have been searching my provider website for that information. I will have my work cut out for me this weekend.

Elvislover I got a lump in my throat My feelings exactly. I understand his desire to protect his family but what about mine? It is a tough position to be in and it angers me.
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Old 02-01-2013, 01:41 PM   #8
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Don't do it, would be my advice. Group coverage is great- right up until you lose it, and then you're screwed. Been there, done that. My personal feeling is that everyone should get private insurance at 18 and keep it, because it will remain portable through every job you have. Group coverage isn't portable, and COBRA is prohibitively expensive. When I changed jobs several years ago, it took forever for me to get new insurance because I had a couple pre-existing conditions and ultimately I had to settle for a cut rate insurer who paid for almost nothing. I finally lost enough weight that I qualified for Blue Cross and switched, but now I'm back to that one year waiting period for my pre-existings. If you have good private insurance that is affordable, then my recommendation would be do not switch.
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Old 02-01-2013, 01:44 PM   #9
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Quote:
Originally Posted by nomorejellybeans View Post
I would make him pay to add you on his insurance and keep paying for your own. I would also keep this to myself.
Most private insurance has a clause that you cannot have secondary coverage or it nullifies your private insurance. That can result in rescission, and even having to pay the insurer back for what they pay for because you violated your contract.

Before the OP considers this option, they need to read their contract with their private insurer to see if such a clause is in there. Both of my private insurers (Celtic and Blue Cross) had that in the contract.
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Old 02-01-2013, 02:38 PM   #10
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EagleRiverDee Thanks. I plan on reading (and re-reading) my contract this weekend.

My gut is to say no. I was avoiding saying this but it is a factor in my choice. My boss and his spouse make 4X my salary combined. I don't know their financial position beyond that, but I do know that they are concerned about the cost of their medication. Loss of this coverage would drive their premiums through the roof. My boss had gastric sleeve surgery and is still losing weight but it requires continued doctor visits and meds. His spouse is morbidly obese and has several allergies and medical issues that are a result of her obesity (knee replacement, etc.). She is working to bring her weight down but at 56 she is unlikely to find insurance with pre-existing conditions and high medical bills.

This is where I feel bad. As a friend/co-worker/human of course I want his family to be well. However, my family is my responsibility and it would be wrong for me to put her family welfare ahead of my own.

At this point there are only two ways out - well three.

1. Keep my personal insurance and deal with any negative feelings my boss may have about me not "saving" his family coverage.
2. Drop my personal insurance and feel like I betrayed my family. Deal with my feelings of resentment for being put in this position and keep my fingers crossed that I keep this job - till infinity!
3. Find a new job and take my insurance with me so I don't have to feel resentment on either side of the equation.
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Old 02-01-2013, 05:24 PM   #11
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I don't know, but wouldn't there be some sort of legal recourse if he fired you for not getting on the office plan? That seems illegal to me.

Either way, it sounds like you should start looking for another job anyway, as you're not going to come out the winner in any situation here, unless he gets over you saying no pretty quickly.

Personally, I would not give up the private insurance if I was happy with it.
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Old 02-01-2013, 05:34 PM   #12
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Quote:
make him pay to add you on his insurance and keep paying for your own. It seems you all feel this is the best course of action. I like the idea and I will have to put on my negotiation hat for this. Since it is a small business and the Board of Directors will have to approve the pay out I will have to dig in my heels. If I can swing it I will definitely keep my mouth shut.
I don't agree with this either. Like Dee said, you can't have two.
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Old 02-01-2013, 05:40 PM   #13
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Legally he couldn't fire me (although I live in an at will state) and maybe I'm not giving him enough credit but I think he could make things " uncomfortable" for me. I

I have explained my reasons to him but it has come up again.
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Old 02-01-2013, 06:17 PM   #14
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Legally he can fire you for any reason, as long as it's not a discriminatory reason. And not wanting to be on the office health insurance isn't a protected status. But more than that, he can come up with any reason he wants and let's face it, chances are most employers can find something to use against you if they want to.

I hope it doesn't come to that, of course! But given what you've described, it unfortunately sounds like - at best - this will damage the relationship and he will resent you not doing what he wants, since I'm sure in his mind, it's perfectly reasonable.

I was thinking - you might try calling your state dept of insurance and ask them about it, just to see if they have any ideas. In 2014, insurers won't be able to deny coverage for prexisting conditions even on individual policies but I don't know how that impacts premiums and they might know more about that.
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Old 02-01-2013, 06:38 PM   #15
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Quote:
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Legally he can fire you for any reason, as long as it's not a discriminatory reason. And not wanting to be on the office health insurance isn't a protected status.
Except that technically it would discriminatory. If she's the only employee that they are requiring to do this, then it's discrimination.

I think if it were me, I'd have a sit down and say something like, "Look- I recognize that you have reasons for wanting to add one more person to the company plan but I'm feeling pressured to do something that won't be good for me or my family and will only be good for you. I'm happy with the insurance I have right now and would prefer to keep it." I think most people are decent people and when framed in a considerate way they will realize they've been pressuring you to do something for selfish reasons and will stop. I've had several conversations with my own employer about things using that tactic.
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