Spousal Affidavits a New Thing?

[floridashores]

I'm hearing from many that employers are requesting affidavits from employees who want to cover their spouses....proving that their spouse is not being offered insurance with their own employer. Does anyone have any input on how to implement this? Any experience with it?

 

[Allysa]

I've had to help implement this on some cases. I'm sure this document could look better, but I have attached the version that I created for the groups I worked on. Feel free to use this as a baseline if you think it's helpful.

 

[glgamerica]

When an employer adopts a spousal carve out provision on their health insurance, it's usually announced to the employees prior to enrollment.

During enrollment, employees who wish to enroll their spouse have to complete an affidavit that the spouse doesn't have access to health insurance through their employer. This affidavit can be just filled out and attested to by the employee or it's possible that the spouse might have to take it to their employer and have the spouses employer sign it.

Self-employed with no group plan, unemployed, retired or spouses who aren't eligible for coverage through their own employer can be covered without issue.

If you are doing a face to face enrollment, you can explain the rules as employees enroll. If it's a self enrolled case, you'll have to make the form available and have employees return it. Post enrollment, you'll need to verify each employee effected has completed the form. If they haven't then the spouse wouldn't be eligible.

I'd suppose from there you'd verify the information provided on the affidavit. Someone else here will have to chime in on whether it's on the honor system after that. I've collected my fair share of affidavits but haven't been involved in the final phase.

Employees don't usually like it but get used to it.

 

[Cenla Agent]

This is usually sent out about once a year for the spouse to affirm that he or she does not have other coverage. I've been self-employed for years and have had to complete the form and return it because I am covered under my wife's group plan.

I think it has to be filled out regardless of the circumstances (i.e. self-employed, other group cvg available, unemployed, etc). I think it goes to the carrier rather than to the employer but I'm not 100% sure.

 

[LostDollar]

Can employers force split enrollments when there are kids involved too? And if so, where are the kids covered?

cenla, not absolutely sure but I think you are talking about a different situation than gigamerica. I think the form you are talking about is what the carriers use to find out if they have coordination of benefit issues.

 

[glgamerica]

Can employers force split enrollments when there are kids involved too? And if so, where are the kids covered?

cenla, not absolutely sure but I think you are talking about a different situation than gigamerica. I think the form you are talking about is what the carriers use to find out if they have coordination of benefit issues.

I haven't seen any children carve outs. I'm fairly certain the Affordable Care Act requires the employer offer coverage for children.

I have heard of employers that offer employees an "incentive" to insure their children elsewhere though. I haven't seen it first hand though.

Which parents medical plan the children would go on when then be a function of which one is a better deal.

It did appear that Cenia was talking about the spousal carve out.

 

[LostDollar]

I haven't seen any children carve outs. I'm fairly certain the Affordable Care Act requires the employer offer coverage for children.

I have heard of employers that offer employees an "incentive" to insure their children elsewhere though. I haven't seen it first hand though.

Which parents medical plan the children would go on when then be a function of which one is a better deal.

It did appear that Cenia was talking about the spousal carve out.

Ok, thanks for the comments. This is one my wife and I never had to cope with. We have had letters requesting info on other coverage-coming in anywhere from 8-18 months apart-the cover material with them usually specifically stated the company wanted the information to see if they had overpaid any claims due to missing legitimate coordination of benefits.

And now I am sitting here wondering if this is another way that business is shifting cost back to employees? I can't remember enough about our rates to think if two individual coverages from two employers cost more than one family coverage from one employer.

 

[ltruitt]

My husband was told that this would happen with his employer, but they never requested one from us.