HR/Medical Coverage Question

[Constant840]

I found out last week that I mistakenly waived medical coverage through my employer this year, while still electing dental, vision and life.
After not receiving a card I called the insurance company who referred me to my benefits coordinator who informed me I waived coverage. I told her I obviously made a huge mistake and she pretty much told me see you next year. She says the insurance company has strict rules about enrollment and correction for enrollment forms and I missed the deadline by two weeks. My wife's employer is willing to provide a loss of coverage letter due to position change which should trigger a qualifying event to get coverage. We did this legitimately in 2016 for my wife without a problem.
This morning I let them know my wife would be changing her position to allow me coverage for the month of March and then revert back to per diem at the end of the month and I'd provide a loss of coverage letter. Now I'm being told I'd have to provide proof of prior coverage and that a cobra notice would be required to trigger the qualifying event.

I'd rather not have to source and pay for health coverage elsewhere when I am supposed to get it free as an employee benefit and at this point am unsure if I even could. I also feel like I'm getting the run around from my employer.

Any HR or benefits wizards out there have advice?

 

[4Waters]

Gotta love Obummer/affordable health care. Sorry I don't have answers for you but I think you are screwed. Can you get on your wife's health insurance with a letter from your employer.

 

[ONE-A-DAY]

The loss of coverage letter has to be generated by your wife's insurance carrier, not the employer, to be acceptable. If your wife and you as her dependent are losing coverage from her employer then the letter will generate and you have to be allowed on to your plan at that time. Its the law.

What insurance carrier are you trying to get on with?

 

[CLdrinker]

Sounds like your HR person doesn’t like you.

 

[Constant840]

The carrier is Cigna.
We pay out of pocket for Kaiser for my wife and daughter as my wife works a per diem position. Her employer would be providing a bogus letter for the sole purpose of triggering a qualifying event with my employers company, Cigna. When she actually went to the per diem position in 2016 I was covered under her plan and a simple letter was all it took to get me covered under my employer. Now they tell me more is needed. I'm unsure why it was enough then but not now? A company of hundreds of people, you'd think there would be an easier way.

So if I'm screwed for getting the benefits I work for, am I still able to source health coverage elsewhere? I technically lost coverage because I opted out. Now that CA open enrollment is closed am I to think I have to go the next year without coverage?

 

[ONE-A-DAY]

The carrier is Cigna.
We pay out of pocket for Kaiser for my wife and daughter as my wife works a per diem position. Her employer would be providing a bogus letter for the sole purpose of triggering a qualifying event with my employers company, Cigna. When she actually went to the per diem position in 2016 I was covered under her plan and a simple letter was all it took to get me covered under my employer. Now they tell me more is needed. I'm unsure why it was enough then but not now? A company of hundreds of people, you'd think there would be an easier way.

So if I'm screwed for getting the benefits I work for, am I still able to source health coverage elsewhere? I technically lost coverage because I opted out. Now that CA open enrollment is closed am I to think I have to go the next year without coverage?

Your screwed. Employer generated letter wont cut it with Cigna, it has to be a system generated letter from the carrier. The personal markets are closed until 2019. Sorry I dont have better news for you.

 

[SBMech]

Can't you just tell HR that the mistake was on their end? That you did not waive coverage?

Or conversely if your compensation package has insurance included, have them cut you a check for whatever amount they are paying and get your own coverage?

You will probably owe more than they were paying, but at least it would help. At the very least you could have them deposit it in a health savings account for you to draw off of when needed....

 

[Constant840]

Your screwed. Employer generated letter wont cut it with Cigna, it has to be a system generated letter from the carrier. The personal markets are closed until 2019. Sorry I dont have better news for you.

Yeah. Covered CA already told me to bad. I was thinking I might be able to directly to carrier and get in that way. Is that not the case?

 

[Constant840]

Can't you just tell HR that the mistake was on their end? That you did not waive coverage?

Or conversely if your compensation package has insurance included, have them cut you a check for whatever amount they are paying and get your own coverage?

You will probably owe more than they were paying, but at least it would help. At the very least you could have them deposit it in a health savings account for you to draw off of when needed....

Package has insurance, but it’s take it or leave it.

 

[ONE-A-DAY]

Can't you just tell HR that the mistake was on their end? That you did not waive coverage?

Or conversely if your compensation package has insurance included, have them cut you a check for whatever amount they are paying and get your own coverage?

You will probably owe more than they were paying, but at least it would help. At the very least you could have them deposit it in a health savings account for you to draw off of when needed....

You cant get your own personal coverage now. The markets are closed until 1/1/19. Once a year sales is the only way the personal plan market will survive because the law prevents medical underwriting now, ie everyoen gets coverage who applies, unlike the old days. If you could buy coverage any time during the year with no medical questions everyone would wait until they get sick and then buy a plan when they need it, unfortunately if that was the case all of the insurance companies would close their doors.

To liken it to car insurance, it would the same as if you could crash your car into a tree and then call up Geico and get car insurance. If that was possible I would cancel my car insurnace tomorrow.

 

[ONE-A-DAY]

Yeah. Covered CA already told me to bad. I was thinking I might be able to directly to carrier and get in that way. Is that not the case?

Same answer, CoveredCa follows all of the guidelines set by the law and the insurance carriers, they are just a middle man.

 

[Constant840]

Holy hell. This is ridiculous.
What about being added to the Kai$er policy already in place for my wife and daughter?

 

[SBMech]

Package has insurance, but it’s take it or leave it.

Seems not quite legal to me, if they offer it, in CA I am pretty sure they have to compensate you somehow?

Bummer man, that sucks.

 

[ONE-A-DAY]

Seems not quite legal to me, if they offer it, in CA I am pretty sure they have to compensate you somehow?

Bummer man, that sucks.

He waived coverage, by mistake I get that, but the insurance company has a form that says he turned it down, once you do that you cant get coverage at that employer unless you have a qualifying event with proof from the current carrier of that event.

 

[ONE-A-DAY]

Holy hell. This is ridiculous.
What about being added to the Kai$er policy already in place for my wife and daughter?

Is it a personal Kaiser policy she has or is it through an employer?

 

[Constant840]

Is it a personal Kaiser policy she has or is it through an employer?

Personal policy.

 

[ONE-A-DAY]

Personal policy.

Nothing can be done.

 

[ChumpChange]

Quit your job and get rehired. New employees get coverage.

Or maybe take this as an omen to interview elsewhere, get a job, and get your benefits back immediately.

 

[ONE-A-DAY]

Quit your job and get rehired. New employees get coverage.

Or maybe take this as an omen to interview elsewhere, get a job, and get your benefits back immediately.

Extreme, but that would work. Assuming they rehire you

 

[ChumpChange]

Extreme, but that would work. Assuming they rehire you

I'm just here for solutions. Don't get lost in the details!

 

[ONE-A-DAY]

Typically the waiver form you signed for Cigna is not sent to Cigna, they dont need to see it, its mainly for the employer to keep in your files to prove that you were presented with the option to enroll and you declined. If the dental, vision, life that you signed up with is not with Cigna, ie another carrier, then Cigna does not know you exist yet. If thats the case and your employer wants to be cool they can put a current hire date on an application and send it in and you will be enrolled as a "new hire". If you had the Cigna medical before, the scenario could be that you were rehired. Your employer just has to be willing to be creative on the enrollment form hire date, if they are you are golden, if they are pricks and dont want to go there then you are SOL.

 

[Constant840]

Typically the waiver form you signed for Cigna is not sent to Cigna, they dont need to see it, its mainly for the employer to keep in your files to prove that you were presented with the option to enroll and you declined. If the dental, vision, life that you signed up with is not with Cigna, ie another carrier, then Cigna does not know you exist yet. If thats the case and your employer wants to be cool they can put a current hire date on an application and send it in and you will be enrolled as a "new hire". If you had the Cigna medical before, the scenario could be that you were rehired. Your employer just has to be willing to be creative on the enrollment form hire date, if they are you are golden, if they are pricks and dont want to go there then you are SOL.

I started to go down that road. They were open to it, but mentioned having an affect on accrued time off and other seniority perks. So they were being both cool about it and pricks at the same time.

I'm exploring one more option. I'll let you know how it works out.

Thanks for info.

 

[ChumpChange]

I started to go down that road. They were open to it, but mentioned having an affect on accrued time off and other seniority perks. So they were being both cool about it and pricks at the same time.

I'm exploring one more option. I'll let you know how it works out.

Thanks for info.

You could always get remarried and get on your new wife's insurance.

 

[ONE-A-DAY]

You could always get remarried and get on your new wife's insurance.

And there is always death as an option as well instead.

 

[ChumpChange]

And there is always death as an option as well instead.

Well that seems kind of permanent! But I like that we're now coming up with multiple solutions!

 

[rrrr]

Well that seems kind of permanent! But I like that we're now coming up with multiple solutions!

Reminds me of the Andy Griffith Show...Andy: "Can't you and your boys handle him?"

Briscoe Darling: "Thought about killin' 'em. Kinda hated to go that far".