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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.

Exclude Spouses from Group Coverage?

By on | 3 Comments

Question: Does an employer document that spouses are excluded, may not enroll in group health plan, through the ERISA documents?

Answer: The group health insurance agreement between the employer and the insurance company providing the coverage typically does not give the employer the option NOT to offer to insure spouses and dependent children or to put it another way - to offer "employee only" coverage. In California, the only 2 exceptions currently are SHOP and Kaiser Permanente.


Thanks for the correction Sara. I had been told by a W&B rep that CalChoice would write employee only contracts. Upon checking with that source today, it appears she was wrong.

Kaiser will also allow exclusion of dependent coverage.

CaliforniaChoice definitively says dependents cannot be excluded from their coverage. it is only SHOP and Kaiser direct which allow the exclusion of spouses.

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