Individual Policies Subsidized by Employer?
- Thread starter 2112Greg
- Start date
- 3,863
Well gray area and depends who you talk to.
One Attorney could argue if an EMPLOYER is paying any portion of the premium that such coverage might constitute a GROUP plan under Texas State Law definition and would need to comply with such GROUP mandates - i.e. guaranteed issue, pre-ex, maternity, COBRA, etc., etc.,
Look at BCBS OF TX INDIVIDUAL application page 1 - "...Will your employer be paying for any potion of this policy..." if you answer YES unless this employer is YOU (i.e. YOUR company) than guess what happens...
AUTO DECLINE!!! It is a trick question and people are declined for individual coverage every day for answering this question YES.
When BCBS OF TX does not allow it - that is a pretty big statement.
- Thread starter
- #13
- 795
Ahh...thanks so much for the info, guys and gals. I'm actually meeting with them tomrrow at noon. It's a 15-person dr's office in a town about 30 miles from Austin...very hometown-ish, old school. I'll let them know the potential ramifications of not having an HRA set up, but I think they will be OK with taking that risk. Were they world-weary, big city folks...that might be a different story.
I'm going to look on the apps to see about employers paying any portion...which technically, they are not...so with proper guidance, I don't think it'll be an issue. And making sure they are fully-informed, I am sure they will be OK with it.
I'm going to look on the apps to see about employers paying any portion...which technically, they are not...so with proper guidance, I don't think it'll be an issue. And making sure they are fully-informed, I am sure they will be OK with it.
- 3,863
Good luck trying to find 15 people that will qualify for individual or without waiver in Texas. Bring some Risk Pool applications with you also... lol...
- Thread starter
- #15
- 795
heh...thanks for the tip! :p
Actually, it went pretty well. Thanks to you all for the advice and tips. They took everything under consideration...and understand the risks, but opted just to keep it simple - which is fine with me.
Actually, it went pretty well. Thanks to you all for the advice and tips. They took everything under consideration...and understand the risks, but opted just to keep it simple - which is fine with me.
- Thread starter
- #16
- 795
Well, hell...it turns out that a few of the people in the office are just below the borderline of making too much money and would lose their CHiPS benefits for their kids. This means they wouldn't be able to take a wage adjustment as it would disqualify them from getting the state benefits for the kids.
Any ideas on how to have the employer reimburse them without it effecting their wages? This should be possible through an HRA, but I'm now told by an outfit that you cannot reimburse HSAs through an HRA. It could be these people don't know what they are talking about (the conversations seemed a little odd to me).
Any thoughts? Please???
Any ideas on how to have the employer reimburse them without it effecting their wages? This should be possible through an HRA, but I'm now told by an outfit that you cannot reimburse HSAs through an HRA. It could be these people don't know what they are talking about (the conversations seemed a little odd to me).
Any thoughts? Please???
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