Reply With QuoteIANAL, etc.
Write them a letter describing why you think they are required to cover you. In the letter, request that they respond to you by certified mail. Send it to them by certified mail.
That should prevent them giving you the phone runaround.
Last month my wife and I had a baby (He's a cute little thing). Prior to having the child we each had individual health coverage through our respective employers. Weighing our post-baby options we decided it made the most sense to enroll in the family health insurance plan offered by my wife's employer. Sounds straightfoward, right?
So I go to my employer, sign the forms, get my insurance cancelled, etc etc. Then we go to sign myself and my son up for health insurance through my wife's employer. They accept my son and reject me. It turns out they don't think that having a baby is a "qualifying life changing event" for a father, only for a mother and baby.
Helpfully, I tried to point out to them that their position seemed to be in violation of the federal HIPAA law. They didn't agree. I asked them (twice) to put them their reason for rejecting me down into writing and both times they dodged that by calling back and offering more verbal explanations to my wife. I think they know (or at least suspect) they are wrong but are willing to stonewall this issue until I go away.
I was able to jump back on my own employers insurance before the cancellation made it all the way through, so I'm not uninsured or anything like that. That downgrades this whole situation to a nuisance rather than a crisis, but it is still bugging me. It seems like too small a thing to go get a lawyer for though. I'm curious what other QT3ers would have done in my shoes or what they may have done in similar predicaments.
IANAL, etc.
Write them a letter describing why you think they are required to cover you. In the letter, request that they respond to you by certified mail. Send it to them by certified mail.
That should prevent them giving you the phone runaround.
Usually you can change those plans at year end/begin - so you can change it in 5 weeks - don't stress - just wait the 5 weeks.
To be honest, this whole issue is really disgustingly complicated. I think the question is how much money are you losing by paying single+parent/child rather than family and are your health benfits inferior to the ones you would get from your wife's plan.
If the answer is "wouldn't save that much" and "benefits are the same" then it's probably not worthwhile. There's also a chance that your wife's plan has provisions forcing you to use the company's own appeals system or forcing an arbiter before you can sue.
Good luck with all of this.
Nope. Wife's employer ties health insurance to their fiscal year, which ends Aug 31st. So open enrollment in their health plan runs Sep 1 - Sep 31.Originally Posted by Phil_Stein
The cost difference between my insurance and putting me on the family plan isn't big, so I'm not really stressing over it. Like I said in my original post, this is a nuisance not a crisis. Otherwise I wouldn't be posting about it, I'd be getting lawyers involved.
In the future, don't cancel and then see if you can get coverage from somewhere else. Make sure you can get the coverage first, then cancel.
DO THIS ALL IN WRITING.
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