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Law Educator, Esq.
Law Educator, Esq., Attorney
Category: Employment Law
Satisfied Customers: 111593
Experience:  20+ Years of Employment Law Experience
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I have had a great health insurance through my spouse years.

Customer Question

I have had a great health insurance through my spouse for many years. But I decided to go back to the work force and my employer has imposed me with a "free insurance" policy that has to be my primary insurance.
This new insurance company just denied me of a much needed operation, and my old insurance will not pick up the tab. They would if they were my primary (totally understandable). These is all affecting my health and quality of life.
Nowhere in my employment contract or paperwork says that I have to accept their policy as primary. I was never given the policy to read it either.
Please let me know your thoughts. I live in Florida.
Submitted: 9 months ago.
Category: Employment Law
Expert:  Law Educator, Esq. replied 9 months ago.
Thank you for your question. I look forward to working with you to provide you the information you are seeking for educational purposes only.
You do NOT have to let your spouse's insurance go. Your employer can mandate you take their insurance policy, since they have group minimums to meet, but you can retain the other insurance. Your spouse's insurance is secondary to this new policy, so they are supposed to pay what the other policy does not cover. This new policy becomes primary by operation of law, not by your choice, because it is your policy from your employer. As it is your policy from your employer it is primary and your spouse's policy is secondary and they are supposed to pay what your first policy does not pay.
You need to file a written appeal to both insurers informing them they are bound to pay under the terms of the policy and your spouse's policy is bound to pay what the primary insurer does not cover. If they deny you a second time, you are still entitled to a third appeal they must send to an independent review and if you lose that you can sue in court for breach of contract.