A lot of companies allow Partner coverage, or they used to. Maybe that’s gone now that gay marriage is legal? Anyway, for those, I guess you could choose one friend.
While SSM is legal now across the U.S., younger people – even those in domestic/romantic partnerships with members of the opposite sex – are less likely to be married now, compared to earlier generations. I would suspect that at least some employers and insurers are recognizing and addressing this.
I don’t know enough about how insurers and employers treat allowing employees to have their non-marital partner covered under their health plan, but it would not surprise me to learn that they would require evidence of co-habitation, joint financial accounts, etc.; I would be a little bit surprised if they would simply allow someone to say, “Jim’s my partner, I want him covered, too.”
Edit: it does appear that (a) yes, you may be able to add your domestic partner to your health insurance, depending on the company, but (b) you do need to demonstrate that you share a residence and are jointly financially responsible for living expenses, and (c) there may be some tax implications.
Thanks!
OP, do you mean opening it up so the employer pays the lion’s share, or opening it up, COBRA-style, where others can be on the plan but have to pay the whole cost?
This is similar to what I was wondering about. I have no kids, so I’ve never had to cover them with insurance. Do companies now require some proof that someone you’re claiming as a child is your child? I’m thinking of families where a cousin may be raised by a family as a member of a nuclear family, but is not formally adopted.
This reminds me of a coworker who brought two children her mentally challenged sister had had into her family. But she formally adopted them.
It would not surprise me if some companies may now indeed require such proof (or, at least, proof of legal guardianship).
When the ad agency where I work was bought by another company three years ago, and we switched over to the other company’s benefits system, I had to provide them with several documents proving that my wife was, in fact, my wife, in order for her to be covered under my health insurance. I had never had to provide such documentation previously, at various other jobs.
I imagine things have tightened up over the years.
One angle to consider is that your city, county and state governments are all employers. @Kent_Clark is not exaggerating when he describes the cost to employers to give health care to a single employee. My city has 12,000 residents and we as an employer insure 75 people. We actually have a hard time getting a company to work with us because our “pool” is so small. Our health insurance costs are enormous.
Since I’m on council I get offered to be on the city health plan, which a previous council somehow finagled even though it’s a less-than-part-time job. I had to log in and waive my right to insurance as I do yearly. I never checked before but I checked last night and my cost would be $50/mo for insurance!!! WOW!! But I decline the insurance and by my own Obamacare plan for $600/mo, because I would cost the city like $10k/year in insurance coverage for me. Yuck.
Anyway, imagine your city, county and state taxes going to pay for health insurance because “it would be nice” to let city employees (who mostly don’t even live in the city) insure their friends or relatives. If one person’s insurance costs the city $10k/year, and there are 12k people, that’s 83 cents per resident (children included) per year to insure some rando. If the 75 employees all did it, and each got one extra person, it would be $62.50/year per resident to insure everybody’s buddies.
That’s insane.
Health insurance is a HUGE cost to businesses and governments and I have no idea why they aren’t pushing back on the US Government to get universal health care and take the burden not only off the people but off the companies.
I’m sure it would be relatively easy for an employee to add a random, under 26-year-old to their insurance policy. Their employer is not likely to verify the relationship. But if the insurance company ever found out that the person was not the legal child of the employee, they would likely come after the employee for any payments the insurance company paid out. I’m guessing it would be considered insurance fraud.
I forgot about that! Yeah, with penalties, it could end up costing more than just purchasing the insurance.
They haven’t tightened up from my perspective - my employers have always verified all of this. My kids are in their 30s and I have always had to prove that they are my kids to cover them on my insurance - I even had to send their birth certificates to the insurance company that paid for their delivery. I can cover all sorts of kids - bio, adopted, step , the children of my domestic partner but I have to prove their relationship. There’s even a provision to cover “other” kids, which I assume means kids you have legal custody or guardianship of , because documentation is required for those kids as well. With all these requirements , I am 100% sure they would not cover my brother’s kid who is informally living in my house.
Also had to provide a marriage certificate to cover my husband - and I could only cover a partner if we had an official domestic partnership ( and I could not add a domestic partner if I had covered someone else as a domestic partner within the past year).
Since about 2004 my employer has conducted audits where I have to prove that everyone is still eligible, and that I do not still have my theoretical ex-husband or former stepchild on my policy. ( I have to provide tax returns with financial info redacted, but they want to see that I’m filing “Married” something)
Thanks for all the info!
Asking as a curious foreigner: how is the price of health insurance determined in the USA? It seems from what some of you have said that it depends not only on your personal circumstances (age, gender, etc.) but also on your particular employer? The cost of health insurance as an individual can be substantially different to the cost of getting it through your employer? That sounds like an absolute nightmare. How do you know, when contemplating a new job, what your costs and coverage will be?
(We actually have health insurance here too [I am in South Africa] because the public health system is, let’s say, insufficient. But an insurer here has to charge the same price for everyone who chooses the same benefit option, regardless of employer or personal circumstances.)
You can probably get the cost of your insurance from your employer before you start, as part of the benefits package.
Employer-provided insurance is a group policy, so the price is the same for all the employees, regardless of age (although smoking status can raise the cost). It’s a different cost if it’s just the employee who is covered, vs. employee + spouse, or + kids, or + kids and spouse.
Different companies chip in different amounts, and probably also negotiate better or worse deals. Large companies will be able to lower the costs because they have a larger pool of employees.
For most jobs, you have to ask while you are in the interview process. For some jobs (some government and union jobs) it’s available online.
And the cost of getting it through your employer can be much different than paying yourself - the family coverage at my employer was $2071 per month but my share was about $500.
But it’s not so much that insurance companies charge different companies different rates for the same coverage (although that might happen) - there are various policies with different coverages offered by the same insurance company and different employers pay different amounts, so another employer in my program might pay only $1000 of the cost per month, leaving the employee to pay the other $1071 and a third might pay the full premium so the employee pays nothing.
For new employees, we require evidence that the indivdual they list as a dependent is in fact a dependent. That means birth certificates, marriage certificates, court documentent demonstrating guardianship, etc., etc. If they don’t have that documentation we don’t allow them to cover the dependent.
Yes, absolutely.
If you’re getting health insurance through your employer, you will almost undoubtedly only be paying a fraction of the total “monthly premium” for the coverage, while your employer will cover the rest, as essentially an employment benefit. This site indicates that, on average, U.S. employers pay for 78% of the monthly insurance premium for an individual, and an average of 66% of the premium for a family (i.e., the employee and their spouse/dependents).
If you have to buy your own insurance (because you’re unemployed, self-employed, working part-time (many employers only provide insurance to full-time employees), or working for a small business (which can opt to not offer insurance), you’re on your own for paying for it. (However, many Americans with modest incomes can get a Federal tax subsidy, which reduces the cost of buying your own insurance.)
How aware is the average US employee of the actual cost of their employer’s contribution - is it something that would appear on your pay stub? When you get a job offer with a salary amount, does that amount include the employer contribution or is that treated like a separate benefit?
(Sorry for all the questions, I find these “how do mundane things work in other countries” questions oddly fascinating. 
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Can individual policies vary on age and so on? So for an older person, losing their job can mean that their health insurance costs shoot up?
(Disclosure: I work in advertising, and my primary client is a major regional health insurance provider, so this is the kind of stuff I deal with at work every day. 
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Most employees, in my experience, don’t realize the full cost of their employer-based insurance. The share that employees pay is usually deducted from each paycheck (and the “employee share” of the cost would appear on the pay stub), and during “annual enrollment,” employees are typically told what their payment (either per month, or per paycheck) will be.
Some employers may tell their employees what the total cost is of their health insurance (so that employees have an appreciation for just how big of a benefit it is to them), but in my experience, most don’t do so.
Upthread, several of us mentioned COBRA, which is a Federal law that allows someone who leaves an employer to opt into retaining the health coverage which they had while employed – people typically look into doing this if they are not immediately moving to another employer which will be providing health insurance. However, if you opt in for COBRA, you will be required to pay 100% of the premium cost, which is often a tremendous “sticker shock” for many.
Your salary amount wouldn’t include the amount of the employer contribution – that’s a separate benefit.
Premiums for individual coverage aren’t based on age, nor on any pre-existing condition – but, as already noted, buying an “individual” plan is usually a lot more expensive to a person than getting a comparable policy through their employer, so losing your job (and having to buy your own insurance) will mean that most people, regardless of age, will see their health insurance cost shoot up.
Also, note that, once an American turns 65, they almost undoubtedly will qualify for Medicare, a federally-run health insurance program – but “base Medicare” doesn’t cover everything, which is why most Medicare-eligible people also buy a supplemental plan (from a private insurer) to cover some of those costs.
It appears on the pay stubs at my company. I sometimes get calls from employees upset that their premiums seem so high, only to realize they’re looking at the employer contribution and not their contribution. Some companies will give new hires their total compensation which will include their salary and benefits. I.e. Maybe you make $57,000 a year, but your total benefits are $72,000 a year. Most candidates are more interested in their salary than they are in benefits.
Not usually on the pay stub - the form we get reporting our wages for the year (W2) has included the cost of health insurance since around 2010 or so. I don’t know how many people bother to look at it- I’m guessing not too many since it’s just there for information and isn’t needed to complete the tax forms.
When you get a job offer with a salary amount, does that amount include the employer contribution or is that treated like a separate benefit?
Not in the salary amount - and in fact , I think it would be unusual for an employer to even publicize exactly how much they pay. My employer included in various documents and websites exactly what percentage they paid for the employee and dependents for which union and which salary grade - but to find out the dollar amount they paid for my insurance I had to take the total cost (from my W2 or COBRA materials) and them subtract my share.