Does anyone know if on a graded self-funded group employer health plan, can an employer implement a higher deductible for spouse and family coverage than for employee only coverage? 155 life group in Florida. Currently, they have a $3000.00 ind. $6000 family. I’m trying to get creative here. The owner would like to drop employee’s deductible to $1500 and increase spouses and families to $4000. Anyone have suggestion? Thank you.
Shifting deductible, mid sized graded funded plan
- Thread starter JamesP
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Use an HRA, may have some contract issues with reinsurance.
Am I misunderstanding you? You say the currently have a family deductible of $6,000 and you want to increase it to $4,000...makes no sense. If you want to raise the plan deductible you need to coordinate with administrator. May not allow it.
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Thank you for the suggestions! This group is a bit of a pain, well the owner is. He wants to discourage the spouses from taking coverage, yet he’s only charging them approximately $233 a month for the coverage. I told him to increase that, and he said he didn’t want the employees to have additional deductions, as he pays them terribly low wages. He runs the company like they’re in the military. He has two employees who’s spouses make a ton of money, but are self employed, and he’s mad because he pays their insurance. He wanted to exclude them, I let him know this was not legal, and he continues to try to find a way to accomplish it. Uggg!
Michelle Chase
Expert
- 22
There is a solution!!! If you would like to discuss further please message me. The group information should stay private.
What is the solution?
