Job Offer: Exchange Health Insurance for Higher Salary?

Question

This question is from the United States.

Summary: I am looking for a job with better health insurance. I want to negotiate higher salary instead of offered plan and be self-insured, is it reasonable?

---

I am currently looking for a new job for a variety of reasons. One of the reasons is to find better health insurance. The insurance with my current employer is pretty bad. Issues include:

• Most claims are denied by default. Either there are a lot of phone calls to get basic care covered or the claim is not covered at all. For example, they denied coverage for the COVID booster shot. In the meantime, I had a coworker who died during the pandemic. This is not a good combination. Other coworkers are having critical treatments denied, and I worry about them.
• When the insurance company does cover, the proportion is minimal. I have had to pay 70% of the costs out of pocket for some claims. Combine this with the cost for premiums, it is almost like I have no health insurance.
• The runaround is so bad, that employees typically don’t even go to the doctor, to avoid dealing with the insurance.

So, I have been looking for a new job. For some employers, I get pretty far along in the interview process. It seems like good work and good coworkers. Then HR gives me a copy of their benefits, and I find out it is the same insurance or not much better. So, I cancel the interview process, because I know that I would not accept any potential offer because of the insurance.

I have had this happen a couple of times. I do not know if this is the state of health insurance right now in the U.S., so I was trying to consider another option.

Would it be reasonable if I get to the point of the job offer, then refuse the company’s health insurance, and ask them to give me a higher salary instead, so that I can pay for insurance out-of-pocket, choosing my own plan from the market? I am single with no children, and that is not going to change. I have decent health, no major issues. I have looked at the market, and a plan that I am interested in is $600 per month, $7200 annually. Note that I am looking for decent insurance, not perfect. Basically, I would refuse the company insurance and ask for $7200 more per year in salary. Do you think companies would balk at this idea or is this a reasonable negotiation point for a job offer?

Please let me know your thoughts.

Please avoid any political rhetoric in responses. I am looking for practical suggestions for my current situation. Any feedback along those lines would be much appreciated.

Answer 1

Would it be reasonable if I get to the point of the job offer, then refuse the company’s health insurance, and ask them to give me a higher salary instead, so that I can pay for insurance out-of-pocket, choosing my own plan from the market? I am single with no children, and that is not going to change. I have decent health, no major issues. I have looked at the market, and a plan that I am interested in is $600 per month, $7200 annually. Note that I am looking for decent insurance, not perfect. Basically, I would refuse the company insurance and ask for $7200 more per year in salary. Do you think companies would balk at this idea or is this a reasonable negotiation point for a job offer?

Some companies do allow this. If you refuse the health coverage they give you something in return. Offers that I have seen, though I was not interested in them because I needed the insurance for my family), include:

• The amount of money the company would have paid for their portion of the premium.
• A extra percent match in the 401(k)
• Extra vacation days.

I even had one company which gave everybody X of you were single, or XX if you were married, each pay period to cover their optional benefits. If you picked all the options you would use all the money up, and have some withheld from your check. If you picked only a few options you had extra pay.

People who pick this type of option are typically:

• Married, and the insurance coverage comes from the other spouse.
• Under age 26 and getting coverage from their parent.
• Retired from the military, and getting their coverage from their military retirement.
• Age 65 or over and on medicare.

I would think that companies that have a lot of former military would have this type of option available.

Answer 2

Would it be reasonable if I get to the point of the job offer, then refuse the company’s health insurance, and ask them to give me a higher salary instead, so that I can pay for insurance out-of-pocket, choosing my own plan from the market?

Do you think companies would balk at this idea or is this a reasonable negotiation point for a job offer?

In any company of any decent size, that simply isn't going to happen.

There's no value to the company in having one less insured employee on their payroll. If you don't want/need their insurance, you aren't going to get a higher salary.

Consider becoming an independent contractor. You won't have the option of employer-provided insurance. Then you can choose whatever insurance you can find on the marketplace, and pay for it yourself.

Answer 3

[LATE EDIT: I should have started by saying that, in the US at least, the company generally just offers plans that they have negotiated and are willing to subsidize. You still pay the remainder of the plan cost out if you income. That remainder may be zero. It is possible, though uncommon, that if you decide to not take advantage of any of these group plans you may be able to get part of the subsidy as cash; ask your employer. However, note that group plans are usually more cost-effective than individual plans, do unless there is some other group you belong to with statistics as good as or better than the employees at your company, or some other subsidy (military veterans, perhaps) that is available only if you buy their preferred plans, or you are willing to cut coverage drastically, you are going to have trouble finding a better deal than the employee plan.]

I think this has to be a personal decision based on your health, your financial ability to handle unexpected emergencies, your confidence in your ability to evaluate insurance offerings, and whether you can actually find anything that is comparable cheaper.

Note that companies often subsidize employee health insurance, and that there are tax advantages for them partly paying you in this form rather than in cash. Also, you are asking for something that may be outside their normal accounting options. So they may be unwilling to consider the idea, or at best may offer you less than what you would pay for an equivalent policy on the open market.

Group policies are also often less expensive per person than individual policies, for statistical-averaging reasons. Especially if you have any prior health issues that might affect quotes.

Finally, larger companies often already have a policy offering with no cost taken out of the employee's paycheck. Those can be pretty decent policies too. They are likely to simply point you to that.

Personally I wouldn't suggest trying to negotiate on this basis. Just negotiate salary normally.