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Ask the Health Insurance Expert

I live in Louisiana and work for a small doctor's office that has three employees. None of us have insurance. Is it illegal for my employer not to provide health insurance? Also, is there a portion of the premium or percentage of the cost he should be responsible for paying if we find our own health insurance?

No, there isn't a law that requires an employer to provide medical insurance, even if the employer is a doctor. Health insurance is a benefit that employers can choose to provide for their workers. There also isn’t any rule that your employer must cover part of the cost of individual health insurance.

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But you might be able to lobby for the office to get a small-group health plan if you propose that employees pay 100 percent of the premiums, which may provide a better deal than shopping for coverage completely on your own. However, group plans may include state mandated benefits you don't need and may not want to pay for.

A downside of individual health insurance is the lack of coverage for pre-existing conditions. A pre-existing condition is a health problem for which you've already been treated before applying for insurance. Thanks to health care reform, insurers can't deny coverage for children's pre-existing conditions, and starting in 2014, they will not be able to deny coverage for adults' pre-existing conditions.

Also beginning in 2014, individuals and small businesses will be able to buy health insurance through so-called health insurance exchanges. These will serve as one-stop shops, making it easier to get information and compare plans side-by-side. That's also when the individual mandate goes into effect, which requires everyone to have health insurance. The requirement that everyone have insurance was included in the health care reform legislation to provide a large enough risk pool so insurers could cover pre-existing conditions.

For more, see the basics of group health insurance.

Last updated: Feb. 9, 2011
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