Can My Employer Offer Health Insurance Through An HMO That Is Not Available To Every Employee?

That might not sound exactly fair, but it is legal. Your employer is free to determine which employees will be eligible for their health plan. A 90’s style “dot com firm,” for example, could choose to offer health insurance to their programmers and sales staff but not to their site designers.

Nevertheless, every employee in whichever class the company chooses must be given the opportunity to participate in the plan. Your employer can’t offer its health plan to only a select number of employees in that class.

Moreover, once your employer’s insurance provider, PPO or HMO offers group coverage, no employee who qualifies can be denied coverage because of pre-existing health problem.

Your group plan will be free to conduct screenings of the medical histories of individual eligible employees, but only to decide whether it should reject or accept your employer’s entire group and settle on what group premium it should charge.

In the case of small businesses however, certain states are now requiring what’s known as "guaranteed issue coverage;" meaning that insurance company’s can’t refuse coverage to a group, even if one or more employees has pre-existing health problems.