As a business owner you have the option to waive coverage of Workers Compensation insurance. The question you must ask is…are you covered by your group health plan if you have waived Work Comp? Each carrier has different exclusions and limitations as it pertains to accidents on the job. Below is a summary of the legal language from the five main health insurance carriers in Utah. Select Health “This is coverage for business owners, including partners and sole proprietors, for services resulting from work-related accidents not covered by workers’ compensation insurance. This benefit is not a replacement for workers’ compensation insurance.”1
- Select Health is the only carrier that offers 24-hour coverage without limitations. There is no additional cost, or notification needed.
Altius “Charges in connection with a work-related injury or sickness for which coverage is provided or would be provided under any workers’ compensation, employer’s liability, or occupational disease law. When the employer is required by law to have such coverage, this exclusion applies whether or not such coverage is in effect.”2
- Groups must list all non covered owners on the group application at the time of enrollment, or notify Altius if any changes are made that omit owners from Work Comp coverage after the group health plan has been established.
Regence Blue Cross and Blue Shield “Employer must carry Workers Compensation on all enrollees; however, 24-hour coverage is available and required for business owners who are not covered by Workers Compensation.”3
- Groups must list all non covered owners on the group application at the time of enrollment, or notify Regence if any changes are made that omit owners from Work Comp coverage after the group health plan has been established.
Humana “A sickness or bodily injury which is covered under any Workers’ Compensation or similar law. This limitation also applies to a covered person who is not covered by Workers’ Compensation and lawfully chose not to be.”
- Groups must indicate if 24-hour coverage is needed at the time of quoting or application. If needed, a 2 to 3% load is added to the rates for the whole group not just the owner. If not elected the limits and exclusions apply.
- United Healthcare requires notification on the group application, but if you read the Limits and Exclusions, the contract won’t cover claims if the owners “could” have elected the coverage.