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Should Group Health Insurance Plans Have A Weight Requirement?

Should Group Health Insurance Plans Have A Weight Requirement?

It is common for individual health insurance policies to exclude applicants for a variety of factors

. One of the most significant is the potential policyholder's weight. In most cases, a person with a BMI (body mass index) over 30--which is considered obese--will have to pay a higher monthly premium. This is due to the increased likelihood of them needing expensive treatment. Depending on how overweight a person is, they may be unable to purchase a standard plan entirely. Instead, they can buy high-risk health insurance intended for people with pre-existing conditions. However, those plans are typically more expensive.

Those able to take advantage of group health insurance through their employer have typically been able to avoid that pitfall. Since employer-based insurance has the ability to spread the risk of coverage among a larger group of people, the health status of any one individual has less of an impact on costs. Therefore, all workers are normally able to have coverage.

Unfortunately, some smaller employers--as well as local governments looking to save money--have put limits on which employees can sign up. For example, in McDonough County in Illinois, the group health insurance plans for county employees exclude employees who are over 100 pounds overweight. At that level, the vast majority of people are considered to be morbidly obese.

The County Board finance committee's panel just voted to eliminate this barrier to coverage. While it could be considered as a moral hazard, encouraging the obesity epidemic, quality health care is essential for helping people lose weight and improve their health status. Moreover, since the Obama administration's recently passed healthcare reform law will ban insurers from refusing customers based on health status, the county simply wanted to waive the requirement several months earlier than legally mandated. The new rule will be retroactive, taking effect as of September 1st.

Specifically, one employee threatened to quit after losing enough weight to qualify for the insurance plan and then gaining it back. The county reasoned that they are potentially losing talent to other employers without such restrictions.

Should Group Health Insurance Plans Have A Weight Requirement?

By: Yamileth Medina
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