Fiancé and health insurance

[Roklimb]

I have health insurance at my place of employment. I had my fiancé
On my insurance for the past 2 years and recently
My employer told me that she could not be on the ins. We have been
Living together for the past 4 years, and they have covered her for the
Past 2 yrs.. Is this legal?

 

[disagreeable]

Yes, it is. Many insurers refuse to insure non relatives. They likely only added her as you were supposed to be getting married. Since you did not complete the deal, they dropped her.

 

[cbg]

There is no legal obligation for them to cover you just because you are living together. If she is no longer a covered dependent as defined by the plan, they not only may, but must, drop her from the coverage.

 

[Disabled Vet]

What?? about states that doesn't accept marriage between gay partners...... I think this could fall under the "PAST Practice".... if they allowed it in the past. what is that called... domestic partner. Seee if your company offers insurance for Domestic Partners. If so, then you would have a good case for boy friend/girl friend coverage.

My wife does health insurance in Indiana only small group plans, she said She can't think of any insurance company that would insure boyfriend/girlfriend. She said "now maybe on a large group this could be done." Some company's will do domestic partners but not boyfriend/girlfriends.... WHAT??? how can this be because that would be discrimation.. She said it's because boy friend/ girl friend can legal marry as where it's not legal for domestic partners to marry... again WHAT..

I would say it's legal for your company to change their minds about what they offer their employee's. it's their dime. I don't know jack about laws. I just love reading about issues that folks have and how some folks think they can resolve their issues. This board has a lot of great folks that will give you some solid advice. I hope you find some good answers. Please check and see if your company is going to cover domestic partners still.. Please let us know

 

[cbg]

FYI, everyone, this is what I do for a living. Trust me when I say that I know what I'm talking about.

Every group insurance policy has a plan document that governs the policy. The employer MUST follow the plan document right down the line. The plan document is the law, and the company can get in trouble with the law for not abiding by it. Both the IRS and the US DOL have their fingers in that pie, and depending on the state, some state governments too.

Among the items in that plan document will be a list of what dependents are eligible to be covered on the policy, if any. At least as of 2012, in 48 states there is NO requirement that an employer offer health insurance at all. There is NO legal requirement that ANY dependents be covered. There is NO legal requirement that domestic partners be covered. IF domestic partners are covered, the plan document will define what is required for an individual to meet the definition of a domestic partner. (Mingled funds, how long living together, same- or opposite-sex, etc.).

There are three possibilities, and in only one of them is the employer's action illegal.

1.) The fiancee has never been an eligible dependent under the plan and should not have been covered at all.
2.) The fiancee was an eligible dependent, but due to either a change in the plan document or a change in her status, she is no longer eligible.
3.) She was and is an eligible dependent and the employer just doesn't want to carry her any longer.

Obviously I cannot read the plan document to see which of these options it is. But ONLY if #3 is true, is there any illegality involved. If #1 or #2 is the case, and the odds are very much in favor of that, then it would not only be legal for the fiancee to be dropped, it would be illegal if they DIDN'T drop her. I'm not saying it never happens, but most employers are very much aware that (first) all such plans are subject to audit by the DOL and that if they force the dropping of an eligible dependent the DOL will be on them about it and (second) that it's very easy for the employee to see who is and is not eligible simply by asking for a copy of the plan document (which they MUST be given on request). So unless this is a very stupid employer (and yes, I am aware that there are some very stupid employers and also some that think the employees will neither question the decision nor check on its legality) the odds are VERY much in favor that the fiancee either never was, or is no longer, eligible to be covered. If that is the case, the employer MUST drop her.