Lawman Posted May 21, 2008 Share Posted May 21, 2008 I am an elected official in Texas. The county pays for a health insurance policy on me that I don't want..I'm told I cannot opt out..Do I not have the right to decline insurance I don't want? Link to comment
Mike Posted May 21, 2008 Share Posted May 21, 2008 I think a good place to start would be with the Texas Department of Insurance. In my experience, the state insurance departments are a good source of information for the consumer. Link to comment
motoguy128 Posted May 21, 2008 Share Posted May 21, 2008 Couldn't you just not use the insurance? Are you expecting money back for opting out? That might be the issue, they don't really want to give you anything back for not using it. Link to comment
Mark K Posted May 23, 2008 Share Posted May 23, 2008 I doubt if you can opt out. The premiums they pay on your behalf amount to a deduction (for them). They would rather pay those premiums (even if you don't use the coverage) than pay you the difference in salary. If paid to you, the FICA taxes would be an additional expense to your employer. I'm sure someone with a clue will now jump in and tell me I'm full of it, but that's my limited understanding. Link to comment
Bob Palin Posted May 23, 2008 Share Posted May 23, 2008 There's probably more to it than just paying you the extra, the group plans I've been in usually required that all employees were a member, that's probably how they do the actuarial calculations. Link to comment
motoguy128 Posted May 23, 2008 Share Posted May 23, 2008 There's probably more to it than just paying you the extra, the group plans I've been in usually required that all employees were a member, that's probably how they do the actuarial calculations. I think that's the issue. If most healthy people dropped out of large group plans and went to high deductible emergency only tpye plans that better suited them... health insurance would be insanely expensive. Healthy people susidize those unlucky folks with less favorable genetics that have lots of health issues or those that lead a unhealthy lifestyle. I can't remember the exact number but it was somethign like 80% of heathcare expenses are paid to 1% of the participants. It's the exact reverse of taxes, there the upper 1% pays something like 70% of the taxes, but only has 1% of the voting power to decide how it's spent.... so the system is balanced by them choosing the elected officials and contributing to their campaigns. Link to comment
Lawman Posted May 23, 2008 Author Share Posted May 23, 2008 Here's the rub. I pay for an HMO plan for both me and my wife. I have little or no deductible and I'm fairly satisfied with the service I get for what I pay..My employer pays to put me on a plan that has a $1000.00 annual deductible and then only pays 80% after that..Now because I have a plan through my employer it becomes my primary plan and my HMO that I've had for 30 years becomes my secondary plan and will not pay anything until I've exhausted the benefits of my primary plan..So now that I have two policies instead of one it costs me at least $1000.00 more per year.. Is that screwy or what? Link to comment
Dave McReynolds Posted May 23, 2008 Share Posted May 23, 2008 I doubt if you can opt out. The premiums they pay on your behalf amount to a deduction (for them). They would rather pay those premiums (even if you don't use the coverage) than pay you the difference in salary. If paid to you, the FICA taxes would be an additional expense to your employer. I'm sure someone with a clue will now jump in and tell me I'm full of it, but that's my limited understanding. Since he works for a municipality, they don't care about the tax deduction. I'm not sure if he is covered under Social Security (some municipalities are and some aren't), but if he is they would care about having to pay the additional Social Security and other payroll related expenses. He may also be under some sort of civil service pay scale that can't easily be adjusted. But I'm sure the answer, as was stated before, is that the contract with the insurance company states that everyone in the group must be covered. Link to comment
Lawman Posted May 23, 2008 Author Share Posted May 23, 2008 Dave, Your're right..The contract the county has with the insurer stipulates 100% employee participation. It just seems crazy that I am required to take insurance I don't want that is inferior to what I already pay for and that costs me a great deal of money by way of deductibles and makes the policy I am already paying for worthless to me.. Oh by the way just to let you know I just took out a million dollar life insurance policy on you with me listed as the beneficiary... Link to comment
Bob Palin Posted May 23, 2008 Share Posted May 23, 2008 I guess you'll have to switch your family to a non-HMO policy that you pay for yourself, that usually means they will cover the deductible on the primary plan (but check!). Link to comment
Dave McReynolds Posted May 23, 2008 Share Posted May 23, 2008 Dave, Oh by the way just to let you know I just took out a million dollar life insurance policy on you with me listed as the beneficiary... I guess I'd better make sure you don't ever meet any of my climbing buddies. I'm sure for $1,000 and a new rope one of them could be convinced to cut me loose.... Link to comment
Mark K Posted May 24, 2008 Share Posted May 24, 2008 Since he works for a municipality, they don't care about the tax deduction. Yep. I guess I missed that part. Link to comment
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