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Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.


Spouse's Group Health Coverage Too Expensive

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Question: My husband works for a large mechanic shop. He was offered insurance and was told that I his wife am ineligible for any plan cheaper than $500 a month. Individual plans are much cheaper than this and I find that amount preposterous and the reasoning even more absurd. The employer stated “26 is a time to have babies and thats why it is so elevated”.I have no inclination of having kids and find this frankly ridiculous. Other employee have family members covered for less and some are not covered at all and are not offered free coverage as my husband was offered (maybe due to the fact his been there 2 yrs?) Is this even legal what he is doing? Putting everyone in different groups and classifications of his morbid idealisms and basing his coverage on this?

Answer: I get a lot of these “is it legal” what my employer is doing and the answer is “yes” in most cases. So it is with your situation. First, the employer is allowed to make a greater contribution some employees’ health plan premium by classification. For example, a greater contribution to salaried workers than hourly workers, or management and non-management. Secondly, it is common for employers to make no contribution to the coverage of spouses and children. Finally, group health insurance is usually more comprehensive - includes maternity coverage for example. On average, group health insurance will cover 80% or more of your average medical expenses (actuarial value) versus 60% or less for individual health insurance. But that’s why individual health insurance can be cheaper and if you don’t need the extra coverage (maternity in your case) why pay for it. Click here to compare rates now. I think you’ll be surprised how much you can save.

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