Health Insurance: Frequently asked questions

If your employer pays part or all of your health insurance premium, it can require you to participate in the health plan. There is no law that prohibits an employer from doing so.

This requirement may seem unfair, but consider other conditions employers routinely dictate to their employees, including job-related travel, adherence to dress codes, and participation in employer-sponsored workshops or classes.

Employers may demand employee participation in the company's health plan because in some states the insurer can impose "minimum participation" requirements. The insurer may stipulate, for example, that 85 percent of the company's employees must belong to the health plan in order for the insurer to cover the group. This is to make certain that the plan participants represent a mix of healthy and unhealthy employees.

If only the "sick" employees who needed to take advantage of the covered benefits joined the plan, the high number of resulting claims would cause the cost of the plan to soar and threaten it with financial collapse, a phenomenon known as "adverse selection."

For more information, call your regional office of the Pension and Welfare Benefits (PWB) Administration of the U.S. Department of Labor. (The contact information is contained in the pull-down menu featured in Know your COBRA rights.) You also may call the national PWB Division of Technical Assistance and Inquiries at (202) 219-8776.

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