This Day On The Street
Continue to site right-arrow
ADVERTISEMENT
This account is pending registration confirmation. Please click on the link within the confirmation email previously sent you to complete registration.
Need a new registration confirmation email? Click here
$1 buys you full access to ALL of TheStreet's Subscription Services! Learn More

Your Health Plan's Weird Rules

Most of Storck's clients have added a spousal surcharge if the spouse has an option for coverage elsewhere but is on the employee's plan. These surcharges generally range from $25 to $50 per month and are charged whether or not the spouse participates in his or her own employer's health plan.

Can my employer remove my spouse off the company health plan if they become eligible for another group health plan?

Yes, says Lieberman.

"A spouse's eligibility on another health plan is considered a qualified event, which allows the spouse to be removed from the employee's plan," she says. Notification of the event must be provided to the employer within 30 days. The employee will not need to wait until the next open enrollment to make the change.

Does an ex-spouse have to stay on an employee's health plan until the next open enrollment period if the employee doesn't promptly notify the company of a divorce?

No.

"In most cases, an ex-spouse is terminated from the plan and notified of their COBRA continuation rights at the time that the employee notifies their employer of the divorce," Lieberman says.

Can an employer kick someone off the company health plan when they're eligible for Medicare?

No. An employer cannot drop an employee or a spouse from the company's health plan if they become eligible for Medicare.

Leiberman explains the criteria that determine the primary payer for claims:

  • If the group is more than 20 employees, then the group coverage is primary and Medicare is secondary.
  • If the group is fewer than 100 employees and the spouse is disabled, Medicare will be primary and the group plan is secondary.
  • For groups of more than 100 employees, the group plan is primary unless the disabled insured has been receiving dialysis for 39 months, in which case Medicare will be primary.

Here's more from Medicare about primary and secondary payers.

For more answers about group health plans, read Hey, can my employer do that?

Insure.com receives compensation from carriers when readers choose to request insurance quotes. This article is provided by an external partner that is solely responsible for the content.
2 of 2

Select the service that is right for you!

COMPARE ALL SERVICES
Action Alerts PLUS
Try it NOW

Jim Cramer and Stephanie Link actively manage a real portfolio and reveal their money management tactics while giving advanced notice before every trade.

Product Features:
  • $2.5+ million portfolio
  • Large-cap and dividend focus
  • Intraday trade alerts from Cramer
  • Weekly roundups
TheStreet Quant Ratings
Try it NOW
Only $49.95/yr

Access the tool that DOMINATES the Russell 2000 and the S&P 500.

Product Features:
  • Buy, hold, or sell recommendations for over 4,300 stocks
  • Unlimited research reports on your favorite stocks
  • A custom stock screener
  • Upgrade/downgrade alerts
Stocks Under $10
Try it NOW

David Peltier, uncovers low dollar stocks with extraordinary upside potential that are flying under Wall Street's radar.

Product Features:
  • Model portfolio
  • Stocks trading below $10
  • Intraday trade alerts
  • Weekly roundups
Dividend Stock Advisor
Try it NOW

Jim Cramer's protege, David Peltier, identifies the best of breed dividend stocks that will pay a reliable AND significant income stream.

Product Features:
  • Diversified model portfolio of dividend stocks
  • Alerts when market news affect the portfolio
  • Bi-weekly updates with exact steps to take - BUY, HOLD, SELL
Real Money Pro
Try it NOW

All of Real Money, plus 15 more of Wall Street's sharpest minds delivering actionable trading ideas, a comprehensive look at the market, and fundamental and technical analysis.

Product Features:
  • Real Money + Doug Kass Plus 15 more Wall Street Pros
  • Intraday commentary & news
  • Ultra-actionable trading ideas
Options Profits
Try it NOW

Our options trading pros provide daily market commentary and over 100 monthly option trading ideas and strategies to help you become a well-seasoned trader.

Product Features:
  • 100+ monthly options trading ideas
  • Actionable options commentary & news
  • Real-time trading community
  • Options TV
To begin commenting right away, you can log in below using your Disqus, Facebook, Twitter, OpenID or Yahoo login credentials. Alternatively, you can post a comment as a "guest" just by entering an email address. Your use of the commenting tool is subject to multiple terms of service/use and privacy policies - see here for more details.
Submit an article to us!
DOW 17,810.06 +91.06 0.51%
S&P 500 2,063.50 +10.75 0.52%
NASDAQ 4,712.97 +11.1030 0.24%

Brokerage Partners

Rates from Bankrate.com

  • Mortgage
  • Credit Cards
  • Auto

Free Newsletters from TheStreet

My Subscriptions:

After the Bell

Before the Bell

Booyah! Newsletter

Midday Bell

TheStreet Top 10 Stories

Winners & Losers

Register for Newsletters
Top Rated Stocks Top Rated Funds Top Rated ETFs