Commissioner’s Corner

May 2018

Each month the DOI posts short Q & A installments of commonly asked insurance questions and responses from Wyoming Insurance Commissioner, Tom Glause. If you have a question you would like to see addressed or if you want additional information, please feel welcome to contact the DOI at 307-777-7401 or 1-800-438-5768 or at:  www.doi.wyo.gov.  






Employer-provided Health Insurance

Q.  Who regulates employer-provided health insurance?

A. It depends.  Health insurance provided by insurers to Small Group employers (50 or fewer employees) is regulated by the states. However, federal law mandates that an insurer cannot deny coverage to a small business due to the health status or illness of its employees or their dependents. In addition, self-insured health plans (where an employer insures itself), are regulated by a federal law called Employees Retirement Income Security Act or ERISA

Q. Are employers required to provide employee insurance?

A. No, small businesses are not legally required to offer health insurance to their employees. But, under Wyoming law, if an insurer offers coverage to a small group employer, it must offer the health insurance coverage to all eligible employees within that group and it may offer coverage to the dependents of the eligible employees.  Under the Affordable Care Act (ACA), small group health plans must be ACA-compliant and must include the 10 Essential Health Benefits.

Large group employers (50 or more full time equivalent (FTE) employees) are required to provide health coverage to full-time employees or pay a tax penalty. This is commonly referred to as the employer mandate. The employer shared responsibility provision of the ACA penalizes employers who either do not offer coverage or do not offer coverage that meets minimum value and affordability standards. 

Q.  If an employer offers health insurance to its employees, are the employees required to take it?

A.  No, an employee is not required to take the employer-provided coverage.  For example, an employee might find that insurance coverage through a spouse is more beneficial.  However, the ACA’s individual mandate still requires everyone to have insurance (with some limited exceptions).  The individual mandate penalty was removed in December 2017, but the mandate and penalties will continue through December of 2018.