1870.010.35 No Access to Employer-Sponsored Insurance (UWHS) – DSS Manuals

IM-122 December 30, 2013

In addition to being uninsured, the woman cannot have access to employer-sponsored health insurance (either through her employer or her spouse’s employer) that covers family planning services. If the woman declares the available insurance does not cover family planning services, this must be verified by a copy of the insurance plan benefits or other valid plan documents. Access to insurance available through employment includes group memberships or private company insurance enrollment options offered by the employer. Examples of group memberships that could offer health insurance are a union, professional organization, or trade association.

If the woman or her spouse fails to purchase the health insurance, she is ineligible as long as it is available. It is considered available even though there is a limited open enrollment period for which they need to wait.