Can companies make the unvaccinated pay more for their health insurance?

AUSTIN (KXAN) – As COVID-19 cases increase and hospitals in Texas fill with patients battling the virus, big companies are considering using a newer tool to incentivize vaccination: making them pay more unvaccinated workers for health coverage.

Delta Air Lines was the first major employer to announce that it was adopting this tactic. In August, Delta CEO Ed Bastian announced that unvaccinated employees enrolled in its health care plan would have to pay an additional $ 200 in health insurance each month.

Bastian said the increase in premiums for unvaccinated workers was necessary to offset the costs of covering medical bills for workers who ended up in hospital with COVID-19.

“The average hospital stay for COVID-19 cost Delta $ 50,000 per person,” Bastian said in August.

In October, the US Department of Labor gave companies the green light to institute similar insurance surcharges for the unvaccinated – with stipulations. On the one hand, the surcharge cannot exceed 30 percent of the worker’s total monthly premium.

“There is a growing problem and concern about the employer’s ability to provide affordable health insurance to all of its employees, when in reality the impact of the cost of this coverage and the cost increases are growing. in addition according to the individuals. who choose not to be vaccinated and therefore incur higher claims and costs under their health plan, ”said Brian Johnston, principal of the Kansas-based Jackson Lewis law firm.

Joseph Lazzarotti, director of the New Jersey-based employee benefits law firm Jackson Lewis, said with this new federal focus, workers should expect more employers with insurance. self-funded impose surcharges on unvaccinated employees.

“I can tell you that if you get more and more questions, so do we,” Lazzarotti said. “This idea of ​​is going to need a booster and what does it mean to be fully immunized? Because it can potentially affect these programs,” Lazzarotti said.

The Labor Department compared the surtax for unvaccinated employees to the “smoke tax” that some companies levy on workers who use cigarettes or vape pens. Through personal wellness plans, the Ministry of Labor says employers can “reward” workers who choose not to smoke or to be vaccinated against COVID-19 with lower insurance premiums.

The federal agency warns that employers must give their employees the opportunity – at least once a year – to decide whether to get vaccinated and avoid the surtax. Under federal regulations, employers must also offer a reasonable alternative standard to avoid the supplement for employees who cannot be vaccinated due to a health problem.

“If there’s a medical condition that prevents you from getting the vaccine, it’s a whole different situation,” Johnston said. “If you’re in that situation, go see your employer and say, this is my situation, and say, I can’t have the vaccine for these reasons, and they have an obligation to accommodate you based on that circumstance. It’s your right.

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