My employer doesn’t offer health insurance. What can I do?

UPDATED: Dec 31, 2012

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UPDATED: Dec 31, 2012Fact Checked

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Asked December 31, 2012

1 Answer

The Affordable Care Act, or ACA, is designed to increase the availability of health insurance to all Americans. One of the aspects of the ACA is to make sure that you have access to health insurance through the workplace. Employers, by law, are not required to pay for some or all of your health insurance, although many offer to do so as a benefit of employment. When this happens, your employer typically pays for some or all of the premiums, and when they fail to do so, it can have a serious impact on your health care.

Employers with more than 50 employees are required to make health insurance available to their employees, typically through group health insurance plans. Employers who fail to do this by 2014 will have to pay a penalty equal to the cost of health insurance coverage through government sponsored health insurance exchanges, multiplied by the number of employees who are affected. If your employer does not conform to this law, they should be reported, no sooner than 2015, to the U.S. Department of Labor.

If your employer has deducted money from your paycheck to pay for health insurance and you discover that the insurance was not paid, they can be held liable by the insurance company for committing fraud, and may also be subject to prosecution by the Department of Labor because your income has been unfairly withheld.

Your first step should be to contact the insurance company and request a record of premium payments. Determine the number of premiums that have not been paid, or the difference between your payments and the actual premiums. Notify the insurance company of any discrepancies between what you have had deducted and what has actually been paid. The insurance company will then contact your employer to resolve the issue.

Failing resolution with the insurance company, the case would then go to the Department of Labor. It is not that your employer is required by law to provide insurance, though. The problem is that since money has been deducted from your pay that was not then paid to the insurance company, you have been receiving a salary at a lower amount than what is being portrayed in your tax records. That situation would be a case of employer fraud, and could be prosecuted, resulting in severe fines or even incarceration if the employer is found guilty.

Answered December 31, 2012 by Anonymous

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