I am so frustrated--insurance

berrysweet · November 2009

UGH. If anyone has some insight, I would love some. I am so frustrated with this insurance crap, and it seems like the answers that I receive vary from call to call and each subsequent person I talk to. Here's the situation:

-My insurance is currently through my job. I will not be returning to my job after the baby (which the company knows). However, I will still be covered under that insurance because I'll be on "vacation" time when the baby is actually born.

-After the birth, we were going to put me on DH's insurance. However, his HR person insists that my no longer working does not qualify as a life-change event, and that I'll have to wait until open enrollment in March. I know this is not correct...but what do you say when the gatekeeper has incorrect information, and cannot seem to be swayed?!

-We were planning to put LO on private insurance that would cover more than DH's would. But of course, we cannot apply until after LO is born, and the agent just informed me that if the company accepts her, coverage will not be effective until mid-March. I asked what he suggested between January-March, and he said "Uh, I don't know what to tell you."

-I know that typically, in Oregon, a baby is covered under the mom's insurance for the first 31 days. However, I've been told that's only the case if the baby is then actually enrolled in the mother's plan, which our LO wouldn't be because I won't even be enrolled in that plan for very long after birth. Does anyone know if this is actually the case?

I am so fed up with all this, and even more fed up with the fact that there doesn't seem to be any place I can go to get consistent and correct answers!

ELPB · November 2009

Does your work know that you're not coming back? If not, does your insurance carry though your maternity leave- would that catch you up to open enrollment in March?

bananasmomma · November 2009

I would go to your state's dept. of labor website and print of the section on life changing event. Send it to DH's HR person and find out what they say.

littlemaybaby · November 2009

Every company I know of, considers the change in employment status of a spouse a life event. I suppose your DH's company could be different, but I tend to agree with you on this one - that his HR rep may be wrong. Can you speak to her supervisor?

I know nothing about Oregon, but I know my insurance will cover baby for 30 days after birth ONLY if the baby is then enrolled by the end of that 30 days. If the baby is not enrolled by the end of the 30 days, the insurance company is entitlted to reimbursement for any expenses they paid for LO in that first 30 days.

Can you put LO on DH's up front? And then move the LO to the better private insurance in March during DH's open enrollment?

Good luck. DH and I are going through some similar juggling and it's NO fun!

berrysweet · November 2009

littlemaybaby:
Every company I know of, considers the change in employment status of a spouse a life event. I suppose your DH's company could be different, but I tend to agree with you on this one - that his HR rep may be wrong. Can you speak to her supervisor?
I know nothing about Oregon, but I know my insurance will cover baby for 30 days after birth ONLY if the baby is then enrolled by the end of that 30 days. If the baby is not enrolled by the end of the 30 days, the insurance company is entitlted to reimbursement for any expenses they paid for LO in that first 30 days.
Can you put LO on DH's up front? And then move the LO to the better private insurance in March during DH's open enrollment?
Good luck. DH and I are going through some similar juggling and it's NO fun!

The "HR person" is also the owner of the company, so no, I can't talk to her supervisor.

I had been wondering the same thing about putting her on DH's insurance. I'd be fine with that, but will that work even if I am not on DH's insurance at the time of the birth?

JamaicaMon! · November 2009

You no longer working may not be considered a valid life changing event. But the birth of your child should. Typically, he should have 30 days to make changes to his insurance after the birth of a child. I'm not sure how his insurance works, but I know with mine, it will open up completely and I can make changes to everything, not just adding LO. Meaning I could add DH if I wanted to too, or make changes to my FSA, etc.

wallycat · November 2009

Doesn't the baby count as a life changing event? regardless of your job? Can you consider doing cobra until March with the baby on your work insurance if you have to ?

berrysweet · November 2009

wallycat:
Doesn't the baby count as a life changing event? regardless of your job? Can you consider doing cobra until March with the baby on your work insurance if you have to ?

No. The COBRA payment is outrageous. It would be close to $2000 /month for the LO and I. That just isn't feasible by any stretch of the imagination.

littlemaybaby · November 2009

berrysweet:
littlemaybaby:
Every company I know of, considers the change in employment status of a spouse a life event. I suppose your DH's company could be different, but I tend to agree with you on this one - that his HR rep may be wrong. Can you speak to her supervisor?
I know nothing about Oregon, but I know my insurance will cover baby for 30 days after birth ONLY if the baby is then enrolled by the end of that 30 days. If the baby is not enrolled by the end of the 30 days, the insurance company is entitlted to reimbursement for any expenses they paid for LO in that first 30 days.
Can you put LO on DH's up front? And then move the LO to the better private insurance in March during DH's open enrollment?
Good luck. DH and I are going through some similar juggling and it's NO fun!
The "HR person" is also the owner of the company, so no, I can't talk to her supervisor.
I had been wondering the same thing about putting her on DH's insurance. I'd be fine with that, but will that work even if I am not on DH's insurance at the time of the birth?

Okay that TOTALLY sucks about the HR person. I am with you, I really think she's wrong, but I guess you can't go much higher with her!

Yes, you can absolutely add a dependent to DH's insurance even if you aren't on it at the time of birth. His insurance policy should have the same 30 day rule as yours (they'll cover for 30 days assuming you add the child within that period). Talk to his insurance company and they can give you the details - then you just need to make sure the hospital knows that LO will be going on DH's insurance and not yours.

sweetkakes419 · November 2009

I'm an actuary for a health insurer, so I have some experience here but I know that these situations can vary from state to state and employer to employer. Your losing coverage because of quitting your job may not count as a life event, but the birth of your child certainly does. Losing coverage due to losing your job is sometimes considered a life event, but this may be treated differently since you are voluntarily terminating employment.

The birth of your child will certainly allow DH to add LO to his policy, and it MAY allow you to join as well. I have seen different situations. Sometimes, DH would only be allowed to add the child, and sometimes DH could change his coverage status (to family as opposed to employee plus child) entirely. I think you need to get the policy in writing from DH's HR. That's the only way to protect yourself.

Good luck!

oohgrrl11 · November 2009

I would call DH's insurance company directly and ask about this.

I am in MN but LO's birth is considered a life changing event and will allow me to add DH to my policy as well. Also, a spouse losing insurance coverage for any reason, even quitting a job is enough to add them on. I guess states differ but it doesn't sound practical what his employer is saying.

Mrs.KLF · November 2009

bananasmomma:
I would go to your state's dept. of labor website and print of the section on life changing event. Send it to DH's HR person and find out what they say.

Ditto this. As an HR person, I know beyond a shadow of a doubt that losing coverage is a "life changing event". She's wrong.

Second, about the baby. She can immediately be added to your DH's plan. So I would add her to his plan and then cancel the plan once she is covered under the independent plan.

Sorry this is such a mess, Meredith.

Mrs.KLF · November 2009

littlemaybaby:
Yes, you can absolutely add a dependent to DH's insurance even if you aren't on it at the time of birth.

And ditto this. You do not have to be on your DH's plan in order for the baby to be added to the plan.

sweetkakes419 · November 2009

Since you say that DH's HR person is the owner, it sounds like it may be a pretty small company. The owner may just be trying to cut costs however they can by being vague with you, hoping you'll take out your own insurance. Hopefully that's not the case.

Married2MrWright · November 2009

berrysweet:

UGH. If anyone has some insight, I would love some. I am so frustrated with this insurance crap, and it seems like the answers that I receive vary from call to call and each subsequent person I talk to. Here's the situation:

-My insurance is currently through my job. I will not be returning to my job after the baby (which the company knows). However, I will still be covered under that insurance because I'll be on "vacation" time when the baby is actually born.

Then your baby should be covered to...most insurance companies cover the baby for the first 30 days before requiring you to enroll the baby. This allows you time to enroll your baby in your insurance or another one, as you plan to do.

-After the birth, we were going to put me on DH's insurance. However, his HR person insists that my no longer working does not qualify as a life-change event, and that I'll have to wait until open enrollment in March. I know this is not correct...but what do you say when the gatekeeper has incorrect information, and cannot seem to be swayed?!

Having a baby is the life-changing event that should allow you to change your coverage as soon as you wish. My advice? Pay for your insurance through COBRA until you are absolutely sure that you are covered on your DH's policy and your baby is covered on their own (you never know...there could be some delay and you don't want your baby to be uninsured).

-We were planning to put LO on private insurance that would cover more than DH's would. But of course, we cannot apply until after LO is born, and the agent just informed me that if the company accepts her, coverage will not be effective until mid-March. I asked what he suggested between January-March, and he said "Uh, I don't know what to tell you."

See my answer above. COBRA. Or pay to cover your LO on DH's insurance right away and then wait until the private insurance kicks in by March.

-I know that typically, in Oregon, a baby is covered under the mom's insurance for the first 31 days. However, I've been told that's only the case if the baby is then actually enrolled in the mother's plan, which our LO wouldn't be because I won't even be enrolled in that plan for very long after birth. Does anyone know if this is actually the case?

As far as I know your insurance shouldn't run out the day that you give birth. Again, another reason to go with COBRA for a month or two until your DH's insurance kicks in.

I am so fed up with all this, and even more fed up with the fact that there doesn't seem to be any place I can go to get consistent and correct answers!

Hang in there and keep asking the questions until you get the answers you need. Good luck!

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