Is it legally compliant for an employer to exclude spousal coverage IF the spouse is offered coverage from another employer? Are their any rules or regulations to this?
No legal requirement for an employer to offer any coverage to a spouse. Good possibility that more employers will start to follow this strategy in future.
I understand that they don't have to offer it. But it is compliant to not offer it to the spouses who are offered it through their own employer; and only offer it to the spouses who have no other coverage offered?
I understand that they don't have to offer it. But it is compliant to not offer it to the spouses who are offered it through their own employer; and only offer it to the spouses who have no other coverage offered?
Anything I need to do to make sure this is done compliantly. Ie) address it in the handbook? any paperwork or IRS BS to deal with, or its just no big deal at all?
Yes there are things you should do. To begin with it needs to be placed in any/all materials (SPD, SBC, enrollment materials, etc) that would address the issue of eligibility. You should also have a plan and process in place to deal with it, for example how do you verify if the spouse has coverage or does not have coverage? Do you take their word? What about the appeal process from the employee? If I state my spouse does not have coveage at work and you ask for verification I could very well be running up against an enrollment deadline. Do you verify every year?
This can become big problem quickly if you don't get it all baked up front.
So, why are carriers in my state NOT allowing groups to write employee only coverage? Can an employer push this issue, or is there something I am missing?
So, why are carriers in my state NOT allowing groups to write employee only coverage? Can an employer push this issue, or is there something I am missing?
Difficult for me to answer. Not being in your state, I have no expereince with your carriers. If you have anything in writing that you would like me to review, let me know. PPACA is clear on this issue.
