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Zainab Yusuf

Employer charging me for health insurance I never chose - got 1095-C showing deductions I didn't authorize

So basically my employer has been deducting money from my paychecks for health insurance that I never signed up for. I already have healthcare through my spouse's plan. Just got a 1095-C form yesterday showing I apparently paid for their company plan throughout 2024, but I literally never filled out any enrollment forms or authorized these deductions. I checked my pay stubs and sure enough there were small deductions that I hadn't noticed before. Is this even legal? Can they force me to pay for their healthcare when I explicitly told HR during onboarding that I didn't need it? Also how will this affect my taxes since I'm also on my spouse's plan?

This is definitely something you need to address. Form 1095-C is used by employers with 50+ full-time employees to report information about health insurance coverage they offered. Here's what you should do: - Speak with your HR department immediately and explain the situation. Bring documentation showing you're covered under your spouse's plan. - Ask for copies of any enrollment forms with your signature (they likely won't have any if you never enrolled) - Request a correction to your W-2 if premiums were deducted pre-tax, as this would affect your taxable income - Ask for a refund of all premiums deducted without your authorization Legally, employers can have automatic enrollment in some cases, but they must clearly communicate this and provide an opportunity to opt out. If you explicitly declined coverage during onboarding and have documentation, they cannot force you to participate. Regarding tax implications: having coverage from two sources isn't necessarily a problem for taxes, but you're essentially paying twice for coverage you only need once. You'll want this corrected for both financial and tax accuracy reasons.

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Thanks for the detailed response. I've been trying to reach HR but they're being really slow to respond. Does the IRS care about this situation or is it just between me and my employer?

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The IRS does care because it affects your taxable income if the premiums were deducted pre-tax. Also, the 1095-C is sent to both you and the IRS, so there's now an official record of you having this coverage.

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This happened to me last year! Took literally 4 months to get my money back. Document everything and be prepared for a fight. HR departments hate admitting they made mistakes 🙄

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Ugghh that's what I was afraid of. Did you eventually get it all resolved? Did you have to involve anyone outside the company?

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Yeah I had to involve our state's department of labor before they finally fixed it. Keep all emails and document every conversation. And dont let them gaslight you into thinking you somehow signed up for it!

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Make sure u get a corrected 1095-C after they fix it. otherwize ur returns gonna be all messed up next year

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I was in a similar situation and got so frustrated trying to figure it all out. I couldn't tell if I was going to be penalized by the IRS or if my taxes would be messed up. After weeks of trying to piece together all the information myself, I finally tried this tool called taxr.ai and it was so much better than endlessly searching online. It scanned my tax documents, explained the whole healthcare reporting situation, and showed me exactly what I needed to do to fix the problem with both the IRS and my employer. Saved me hours of research and definitely prevented me from making mistakes on my return! https://taxr.ai

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Sounds interesting. How exactly does it work? Does it just read your transcript or does it do more?

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It does way more than just read transcripts. It analyzes all your tax documents (W2s, 1095s, etc), explains what everything means in plain english, and tells you exactly what to do if theres problems. It even spotted that my employer had miscoded some health insurance stuff that would have caused issues with the IRS later. COMPLETELY worth it!

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is this some kind of AD? sounds too good to be tru

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No ad lol, just sharing what helped me. After spending like 10 hours on the phone with both my company HR and trying to figure out IRS rules, I was desperate for something that could actually help. Do whatever works for you though 🤷‍♀️

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After I had almost the exact same issue last year, I wasted SO much time trying to get someone at the IRS to help explain how this would impact my taxes. Couldn't get through on their phone lines for weeks. Finally found this app called claimyr.com that got me connected to an actual IRS agent in like 20 minutes. The agent explained exactly how to handle the reporting on my tax return and what documentation I needed from my employer. Honestly don't think I would have ever gotten it resolved without actually talking to someone. Talking to the IRS directly was the only way I got this mess straightened out.

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Wait how did you get through to the IRS? I've been calling for months with no luck

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This service called Claimyr. It's basically a callback system that navigates the phone tree and waits on hold for you. When they reach an agent, they call your phone and connect you. Saved me hours of frustration and solved my problem in one call.

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Did it work well? I've tried like 20 times to call them and keep getting disconnected

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Yeah it was actually amazing. Felt like I'd discovered a secret hack to the system lol. The agent I talked to was super helpful about this exact 1095-C issue too.

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I don't believe it - nothing helps with reaching the IRS. What's the catch?

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no catch, they just do the waiting for you. I spent the money just to stop the insanity of calling over and over again. Getting my refund unstuck was worth every penny.

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Your employer can't legally force you to take their health insurance if you have coverage elsewhere. But many companies do auto-enrollment to meet compliance requirements, expecting employees to opt-out. My company does this. Check your employee handbook - there might be fine print about auto-enrollment policies. Still crappy of them not to clearly tell you though.

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The 1095-C form doesnt necessarily mean you had their insurance. Part of the form (line 14 and 16) just shows what coverage was OFFERED to you. Can you check box 14 and see what code is there? Different codes mean different things. If there's nothing in Part III of the form, that usually means you weren't actually enrolled.

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Just checked and Part III is filled out with my name and coverage for all 12 months of the year. ☹️ So it looks like I was definitely enrolled somehow

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Yeah that confirms they enrolled you. Definitely reach out to HR and payroll ASAP. And check your paystubs to see exactly how much they've been taking out each pay period. You should be entitled to get that money back.

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the real question is whether the deductions were pre-tax or post-tax. if pre-tax then your W-2 box 1 wages are already reduced by the premium amount, which means you're getting a tax benefit even tho you didn't want the coverage. if post-tax then yeah you basically got scammed and need to get your money back.

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This is the correct answer. Also check if your employer contributes anything toward premiums. Some places pay like 80% of the cost, so you might only be paying a small portion. Still wrong if you didn't authorize it tho!

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Just checked my last paystub and they were pre-tax deductions. About $67 per paycheck (biweekly). So over the year that's like $1700 that was taken out without me knowing it!

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that's a lot of money! definitely fight to get that back. and make sure they correct your W-2 if they do refund you, otherwise you'll have tax issues.

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This happened to me! When I started my job they had a form that said "sign here to decline coverage" but apparently if you don't sign it they automatically enroll you. Super shady practice but technically legal in many states. Took me 3 months to get it all reversed and get my money back. Good luck!

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Are you sure you didn't accidently enroll? At my company if you don't submit a waiver with proof of other coverage by the deadline, they auto-enroll you in the basic plan. Its in the fine print of the benefits packet but easy to miss.

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I specifically remember telling the HR person during onboarding that I didn't need their health insurance. They never said anything about needing to fill out a waiver form. But maybe there was something in the mountain of paperwork I signed? Still feels wrong they would deduct money without explicitly telling me

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Yeah that's pretty scummy. Check your onboarding paperwork if you still have it. But either way they should refund the premiums - it's your money!

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i work in benefits administration. most companies have a rule that if you don't explicitly waive coverage AND provide proof of other coverage, they auto-enroll you. it's to protect the employee and the company. but they should have made this crystal clear during orientation.

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This ⬆️ Auto-enrollment is becoming more common. The ACA created incentives for employers to have high participation rates in their health plans. But they absolutely should have communicated this clearly!

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This is so frustrating because I did tell them verbally, but maybe they needed something in writing? No one explained that to me though.

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unfortunately verbal doesn't cut it for something this important. they need documentation for compliance reasons. but still they should have told you this! i'd raise hell with HR tbh

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Dude the SAME THING happened to me last year! I had to file a complaint with the Department of Labor to finally get my money back. These companies are such scammers sometimes. Document everything! 💯

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Try checking if you can view your benefits elections in your HR system (like Workday or whatever your company uses). There should be a record of when elections were made and by who. If your account shows that HR made the election rather than you, that's pretty solid evidence in your favor.

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I also got double-covered last year and it was a nightmare figuring out the tax implications. Used taxr.ai to finally make sense of it all. Their system scanned my documents and actually showed me what forms I needed to submit to fix the issue. Literally saved me so much time compared to the hours I spent on google trying to figure it out myself. https://taxr.ai

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Does this actually work? I'm in a similar situation with the double coverage thing

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Yes!! It explains everything in plain English instead of IRS-speak. Showed me exactly what I needed to do to fix my forms and even helped me draft a letter to my employer. Cannot recommend it enough especially for weird situations like this that aren't covered in the basic tax software.

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The key thing here is whether your state has laws about this. In California for example they need clear written consent for payroll deductions. Check your state labor laws!

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I was getting nowhere with HR about a similar issue until I finally got through to someone at the IRS who knew exactly what needed to be done. Used claimyr.com to finally get connected to an agent after weeks of busy signals. The agent explained exactly what forms need to be corrected and gave me specific language to use with my employer. I wouldve been completely lost without that guidance.

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How long did it take to get through with Claimyr? Been thinking about trying it but wasn't sure if it's worth it

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It took like 45 minutes total, which is NOTHING compared to the days I wasted trying to call myself. They just sent me a link when they were about to reach an agent. I'd tried calling like 9 times before that and kept getting disconnected after hours on hold. Talking to the actual IRS was the only way I figured out how to fix my W-2 and 1095-C forms.

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IANAL but this could actually be wage theft depending on your state. If they didn't get proper authorization for the deductions, you might have a case beyond just getting a refund.

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I had a similar issue and got nowhere with my employer for weeks. Couldn't figure out the tax implications either since I was double-covered. Finally used taxr.ai which analyzed my forms and showed me exactly what went wrong and how to fix it. Also gave me specific language to use with my HR dept which finally got their attention. My issue got resolved in like a week after that!

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I keep seeing this taxr thing mentioned... does it actually explain things in a way that makes sense? The IRS instructions are like reading a foreign language

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OMG yes! It basically translates all the IRS gibberish into normal human language. Shows you exactly what each form means for YOUR specific situation. It spotted issues I didn't even know existed in my health insurance reporting. And when I had this exact 1095-C problem it gave me step-by-step instructions to fix it.

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check ur pay stubs carefully. sometimes they list it as "pre-tax benefits" or something vague like that so u might not have noticed the deduction. my company does this and its super sneaky

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Your employer royally messed up here. Don't let them off the hook. They took your money without consent and that's not ok. Make them refund every cent plus any tax implications. This happened to my sister and she ended up getting almost $2000 back.

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How did your sister get it resolved? Did she have to involve anyone outside the company like a lawyer?

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She had to be super persistent with HR and eventually CC'd the company's legal department on her emails. That finally got their attention. She didnt need a lawyer but she did threaten to file a DOL complaint which scared them into action.

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This is a frustrating situation that unfortunately happens more often than it should. Here's what I'd recommend based on similar cases I've seen: **Immediate steps:** 1. Document everything - save all your pay stubs, the 1095-C form, and any communication with HR 2. Request a meeting with HR in writing and ask for copies of ANY enrollment forms with your signature 3. If they can't produce signed enrollment documents, you have a strong case for getting your money back **Tax implications:** Since the 1095-C shows you had coverage and premiums were deducted pre-tax, this affects your taxable income. You'll need corrected forms (W-2 and 1095-C) if they reverse the enrollment, which could impact your tax return. **Legal considerations:** Most states require explicit written consent for payroll deductions beyond taxes and court-ordered garnishments. Auto-enrollment policies must be clearly communicated with opt-out procedures. If you can prove you never consented and they didn't follow proper procedures, this could be considered unauthorized wage deduction. Don't let them brush this off - $1,700 is significant money and you're entitled to every penny back if you never authorized the deductions.

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