1. 5527 POINTS
    Marlin McKelvy
    President, Consumer Directed Benefit Solutions, Memphis, Tennessee
    Well, of course you can, you can lie about virtually anything.  The question should be is it ethical to lie about smoking for health insurance?  I suspect that in your heart you know the answer to that question is "No."

    I presume you are asking this question in regard to the smoker's penalty that can be applied to individual health insurance rates and that some employer's utilize.  At this time individual health plans are not requiring a screening test to determine if someone is a tobacco user and are relying on the honor system for applicants to self-report their usage.  There are some employers that take a more strict approach to this matter and may screen you if they require a pre-employment physical.

    To be clear, if you are a tobacco user and you apply for health insurance asserting that you are not then you are engaging in fraud.  Technically this could result in policy termination but my current understanding is that if the fraud is uncovered then the individual policyholder will be back billed at the tobacco user rate and expected to pay all the extra premium due.  However, just because the Affordable Care Act allows for a tobacco use premium penalty does not mean that the health insurance carriers are compelled to apply it.  So, you have some carriers that for administrative purposes at this time who aren't bothering with applying the tobacco use penalty and others who are.  I would inquire with your insurance broker or the insurance carriers you are considering as to what their current rating approach is to tobacco use.  In the employer setting the penalties could be more severe depending upon what their personnel policies are.  Honesty is the best policy.
    Answered on May 13, 2014
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