[Berkie]

Does anybody know if it is unlawful for an employer to offer two group health insurance plans. One is a self insured plan. And the other is fully insured. However, what they do is: they only offer the fully insured plan to employees that they know will have a large amount of impending medical claims, for example a pregnancy. So, they conduct interviews with the employees, identify the ones that they expect will have a high value claim or claims, and encourage them to enroll in the fully insured plan (they, in effect offer them the fully insured plan) For everybody else... they only offer the self-insured plan, thereby putting all of the high risk members of the population in the fully insured plan, and the lower risk folks in the self-insured plan, thereby keeping the cost down

[Fr_Chuck]

Yes I believe that is illegal and violates the rules of qualified benefits, they may offer several coverages but can not force an employee into one or the other.
Sounds like a report to the department of labor

[smearcase]

I don't even believe the interviews are legal. Isn't that a violation of privacy or even Hippa?
Any of us can be healthy as a horse today and into a hospital and Doctors for $ 100,000 tomorrow.
If this arrangement isn't totally out of line, it sure should be.
Like Fr_Chuck says, they can offer a menu type selection but the employee makes the decision based on the benefits of each plan and the premium.
They may have good intentions but its definitely discriminatory.