Plans have been known to exclude coverage for “risky” behavior………
EXAMPLE:
“Care or treatment for injuries/conditions directly related to a Member’s avocation/hobby that is considered to be one of high risk; including but not limited to sky-diving, operating on an all-terrain vehicle, para-sailing, bungeejumping, scuba-diving, operating small aircraft.”
Does refusing to take a vaccination constitute risky behavior?
Specifically can a plan sponsor exclude Covid treatment (particularly high cost hospitalization) if a member refuses to get a Covid vaccination?
We asked an ERISA attorney and he said………..