Small employer new plan – legal?
My company is relatively new. Only 4 of us including owner and we are an s-corp in the US (Indiana). No insurance offered previously. Owner needed insurance so he’s now offering a United Healthcare PPO plan (not listed on their website). There’s no open enrollment period, rep wants our health histories because they can deny you for pre-existing conditions, and if they accept us, our premiums are based on our age, gender, and health histories. They already told me my 16 yo diabetic son won’t be allowed and would have to be on marketplace. Is that even legal? Pretty sure the owner is only offering because this is the best cost plan for him but there are some red flags. He said rep will give him $100 for each of us that sign up. If we sign up it will be deducted pretax and he’ll contribute up to $500, but with no open enrollment it seems like this might not be a true group plan and he’s just running individual plans through the company? What questions should I ask?
I’m currently covered by the VA and we have my husband and kids on an HSA marketplace plan with supplementary insurance through my state that covers my son’s our out of pocket diabetes expenses only (MI – I’m remote).
My husband is self employed – if we are offered coverage through my job then he can’t deduct health insurance premiums on taxes unless we itemize (learned that the hard way with COBRA last year).
I did confirm with marketplace that the employer plan only has to be deemed unaffordable to be able to have a marketplace plan with the premium tax credit, but we don’t qualify for that right now and are paying full cost of our plan anyway so it sounds like we could keep. My son at least would have to be on marketplace anyway.
Owner says it’s not mandatory and I can stay on marketplace, but I’m concerned it’s not a legit offer – I suspect he’s just passing his own insurance through the company to lower his tax burden and if we get on it then he gets a bigger tax break. My thought is if he’s going to offer this as a benefit, then at a minimum it should comply with the law but it’s hard to find out what exactly that is in this situation.
submitted by /u/fallgirl81
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