Susana E. Cano Méndez Sep 1, 2014:

@lorenab23 Thanks for the info, especially about Medicaid. :)

lorenab23 Aug 31, 2014:

in the US yes you do have the option to opt-out and be left with no coverage. There are many reason for opting out such as you may be married and your spouse has a job that offers better coverage and you are included in that plan. Maybe you are the only bread winner in your family of 5 and because of the amount you make you qualify for Medicaid (government insurance) or simply because the employee can't afford to have money deducted of his/her check since the employer never cover the insurance 100%. I used to be an office manager and used to deal with this all the time.

Susana E. Cano Méndez Aug 31, 2014:

Could it be that you have to decide whether to pay more (because you smoke), less (if you don't) or die opting out (because you smoke but you don't want to pay more)? ;)

Sonja Scherling (asker) Aug 30, 2014:

No, if you look up a form in internet employees are offered several medical plan options and at the bottom, there is this final option, as if to declare you want none of the above. The thing is, I am not sure how to phrase this. If this option is chosen, is the employee left with no coverage at all?