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Can my company force me to take health insurance?

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Dear Evil HR Lady,

I just got a full-time job, and I've run into an issue. The only option for medical plans available are high-deductible plans, which cost about $80/month. The plans are 100% employee paid. In addition to the premium, I had to sign a paper stating that I would pay an extra $15 a month because I am a smoker. In lieu of paying $1,000/year for a benefit I will likely not use at all,(I don't ever go to the doctor, so no insurance is no problem) I opted to make a larger contribution to my 401(K) and waived the health insurance. All of the papers I filled out had the option waive the insurance. Even the paperwork "check list" made by HR had the option to waive the coverage. When I turned it in today, I was told that it was against company policy to not take the benefit. This was never mentioned to me during my orientation and it doesn't feel right. From what little I can find online, it appears that a company can make it mandatory to take the insurance offered.

Can you explain how companies can make you take their health insurance? Is my employer getting a kickback from the insurance company? Am I wrong in believing that the omission of this information from orientation is borderline shady? The strong push to take the position, the smoker's premium, and being forced to pay a premium for a benefit I don't want is starting to make me wonder what other bureaucratic nightmares are on the horizon. I don't know a lot about communism, but when I think about communism, I think it's something akin to this. I would rather work for peanuts than to be given the illusion of a choice.

Thank you in advance for any light you can shed on this issue!

Your company is not getting a kickback from the insurance company. (Well, I assume they are not, can't say I've thoroughly investigated them, as I don't know what company you work for.) But if too many employees opt out of the insurance, then the rates for everyone else go up. Why? Because the insurance company assumes it's the healthy employees who are opting out, making their risks much higher.

As for not mentioning it in orientation, I doubt it's shady behavior on the part of the company. Most people are thrilled to get insurance -- even insurance with a high deductible -- at such a low cost. That's why this stuff is referred to as a benefit -- it benefits the employee, and that's how the company sees it. A good thing.

Another reason the company requires you to take the health insurance is that if you do get sick, not being able to get care means you won't be able to work, you'll have high stress which makes the health situation worse, and even when you recover, you'll be buried under bills which will affect your performance level. They are looking out for their self interest as well as yours.

The opt out options may be there because they copied and pasted from a sample form, or because they do allow you to opt out if you have insurance from another source (like a spouse). Why does this make a difference? Because the insurance company knows you're not just rejecting it because you're low risk -- they know you're rejecting it because you have a better deal elsewhere.

The smoker's premium makes sense because you are, in fact, a smoker. You cost more to insure because you are more likely to get sick. I know you feel fine now, but insurance companies don't look at individuals as much as they look at statistics, and you are statistically more likely to get sick than your non-smoking coworkers.

And I'm sure that many of my readers would be thrilled beyond belief to pay $95 a month for insurance, even with a high deductible. (For the record, we here at Evil HR Lady central pay about $1,600 a month for health insurance -- two adults, two children.) We're generally a healthy lot. We don't smoke. We don't drink. We walk, a lot (we don't own a car). We're (mostly) not overweight (we've all got a few post-Christmas pounds) and we drink a lot of water.

That said, two days ago, while in Turkey, a stray dog ran up to my husband and bit him. Turkey has a high incidence of rabies, it turns out. We called our insurance nurse hotline and the nurse consulted with the doctor and the doctor said, "Go to the emergency room now!" Now, after a series of initial shots my husband gets to follow up with multiple additional shots over the next month.

So, aren't we glad we have health insurance?

I know, you aren't planning to go to a rabies infested area. Super. But, you are a high-risk person as a smoker. And even if you are not high risk, you have no idea what 2012 has in store for you. Flu? Bronchitis? Cancer? Broken bone? Pregnancy (if you're female)? Heck, a trip to the eye doctor for new glasses could turn up a brain tumor. If you get really sick (which can happen) you'll be financially destroyed. And then who ends up paying for it? Me. How? Because if you get sick and can't pay your bills the hospital that treats you has to charge higher prices to everyone else to cover the cost of your care.

I do not appreciate that.

Take the insurance. It's part of being a grownup. And put aside some money every month to cover the deductible. Look into getting a health savings account that has roll-over with it. That way you put aside a little money every month, and if you ever need health care, you'll have the money for your deductible put aside.

Have a workplace dilemma?  Send your questions to

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