Can my group health insurance carrier drop me from the policy?

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Jeffrey Johnson is a legal writer with a focus on personal injury. He has worked on personal injury and sovereign immunity litigation in addition to experience in family, estate, and criminal law. He earned a J.D. from the University of Baltimore and has worked in legal offices and non-profits in Maryland, Texas, and North Carolina. He has also earned an MFA in screenwriting from Chapman Univer...

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UPDATED: Aug 13, 2020

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No. If your health insurance policy comes from an employer-purchased group health insurance plan, then as long as you are an eligible employee of that company, you are guaranteed coverage in the group. The same applies to your family members in most cases. If you work for a small employer (generally 2-50 employees), federal law forbids insurance companies from turning down your employer or any of its eligible employees for group coverage. Health insurance carriers also generally must renew its contracts with small employers every year, unless the employer commits fraud, misrepresentation, or doesn’t pay premiums. If you work for a large employer – over 50 employees usually – then the insurance company may reject your entire employer (because of claims history, etc), but it cannot drop individual employees from a valid employer group plan. Only individual plans can exclude individual people.

This requirement to insure regardless of medical and personal history is called “guaranteed issue.” Though larger employers can be rejected as a group, the protections for eligible individuals within valid group plans cannot be taken away. This is one of the main reasons why group insurance exists.

Know your particular employer’s policies and how your situation fits in. Use the employer’s support structure to identify your particular situation, and if you like it, know how to keep it. After all, it is your status as eligible employee, not “valid policyholder,” that first determines your access to its group health insurance plan.

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