Can your health ins co kick off a spouse?

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Posted 12/6/2012 by scrapApea in NSBR Board
 

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StuckOnPeas

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Posted: 12/6/2012 8:31:42 PM
DH came home and told me that I have to get insurance now through my employer because his employer told him their insurance company will check if I'm offered insurance at my work and cut me out. Can they do that? Wouldn't it be just an employer saying that? Not the insurance company?

WT-? He pays for family coverage so now I have to get insurance through my work, which is about $150 a month for just me. It's "self funded" and what I hear from people at work who have it it's so crappy. I know they send emails constantly about how you should find the cheapest services possible. I could just cry. DS broke his leg at school right before thanksgiving, the water heater leaked all over the basement Monday, had to clean up the flooded mess and buy a new water heater, my van need $590 worth of repairs two weeks ago. I know other people have way worse situation but man, I could just cry right now. Oh and apparently DH credit card number was stolen at a resturant last month and we had $600 of additional charges to Mexico on our card. Called capital one and couldn't understand the man with the accent. I sure hope he put in the dispute... I don't even ask what next anymore because I really don't think I can take any more this month.

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Posted: 12/6/2012 8:37:10 PM
I don't know but I do pay a surcharge on my insurance to have my husband insured since he does have insurance available at work.

A girl in my office was insured with her husband on his policy and last year they had to get her insurance at work and his insurance will be the secondary for her. He is still insured by his own policy. Since it was offered at her job she had to take hers as first option they said.

I think we're going to see more of this type of thing with insurance.


Kim

kmk1112
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Posted: 12/6/2012 8:37:18 PM
That sucks, but, yes they can. My company charges an extra fee, beyond the premium, for spouses who have comparable coverage available. It is because they contribute part of the total cost of the insurance.


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Nantini
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Posted: 12/6/2012 8:38:24 PM
We are looking at a plan that only covers the employee only. No spouse, no kids. It totally sucks, but the premiums have risen to 675.00 a month for just the employee!

It's possibly they now have a carrier that is doing much the same thing.



mstubble
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Posted: 12/6/2012 8:39:21 PM
I have found this to be the standard for the last couple of years. Every insurance company that both my DH and I have had for at least the last 5/6 years requires each of us to have insurance through our employer. This year is the first year that my DH would be able to cover me even though my employer offers me insurance but we would have to pay a "fee" per paycheck for this privilege. We decided to keep things the same and each have our own insurance.



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WillowJane
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Posted: 12/6/2012 9:19:59 PM
Wow. This is the first I have ever heard of this practice. I hope other peas chime in to see how prevelant this situation is. We have always used insurance through my job because the plan is so much better than what DH can get. I have never had to pay a surcharge to cover him.

I am so sorry gals - that just bites.



Luvspaper
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Posted: 12/6/2012 9:25:14 PM
yes, they can....it is becoming much more prevalent. especially the surcharge. if they do drop you, it is a qualifying event for you to add even if its after open enrollment, but often you have a limited time period..... thirty days if I remember correctly

for the OP, check to see if DHs plan allows for spouse plUS kids...its often cheaper than family and for this specific situation

kellybelly77
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Posted: 12/6/2012 9:37:45 PM
Yes. It happens all the time as employers are looking for ways to lower their cost. And it's not the insurance company it's the employer.

ETA- all self funded means is that your employer owns the plan, not the insurance company. So your employer is responsible for the financial payment of the claims (up to a certain limit). It doesn't make the benefits or coverage any worse than a fully funded plan sold by an insurance carrier. In fact, most of these plans have better benefits as the employer can afford more coverage when an insurance company isn't in the middle. But those plans are regulated by federal labor law rather than state insurance law so there are less consumer protections that you see in fully funded plans.


Kelly

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Posted: 12/6/2012 9:40:39 PM
Yes, they can do that. They can also ask if a spouse has insurance available from their employer.

I'm not sure they can pick and choose, however, which employee's families they cover, based on whether the other spouse does have other insurance available to them. Benefits is not my area of expertise (though I work in HR) but last I thought I knew they had to make the same offerings available to all employees.

As far as the 'self insured,' that is not uncommon. My company also self insures and though we've historically had rich plans, I can see the path their headed since the ACA passed (I do our HR systems programming).

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StuckOnPeas

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Posted: 12/6/2012 9:42:07 PM
Yes, Dh's company did this last yr. I anticipate more cuts (like all spouses and/or kids) to happen in the future. I don't know what we will do if that happens.

His company just laid off more people so I guess we will be lucky if the offer insurance at all eventually.

Dana

Nantini
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Posted: 12/6/2012 9:45:33 PM
Kelly, in our case it is the insurance company that has raised the rates. Dropping spouses cuts our rate in half. We as a company are still paying the same per employee.

I'm not looking for a way to lower cost and pocket the money. I'm looking at ways to keep people employed and provide some sort of insurance.

I'm not sure where you're getting your info, but it's off base.



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Posted: 12/6/2012 9:56:26 PM
I haven't had insurance for almost 2 years, and two years prior to that it was enforced where I used to work. All married employees, had to pay an extra surcharge if they were employed, and had turned down their own coverage at their place of employment. It's been going on for years at some companies.


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Posted: 12/6/2012 9:58:03 PM
Well, I regulate insurance companies and deal with this every day, but ok.

ETA- maybe i should clarify- when I said employers are looking to lower their costs I meant that because the insurance companies are raising premiums, employers are looking to lower the portion they pay and kicking off spouses is one effective way to do that. In the past 7 years I have been doing this, every single time this has happened it's the employer. The insurance company doesn't care who the employer covers as long as they are getting their money.


Kelly

Jili
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Posted: 12/6/2012 10:02:58 PM

Yes. It happens all the time as employers are looking for ways to lower their cost. And it's not the insurance company it's the employer.

ETA- all self funded means is that your employer owns the plan, not the insurance company. So your employer is responsible for the financial payment of the claims (up to a certain limit). It doesn't make the benefits or coverage any worse than a fully funded plan sold by an insurance carrier. In fact, most of these plans have better benefits as the employer can afford more coverage when an insurance company isn't in the middle. But those plans are regulated by federal labor law rather than state insurance law so there are less consumer protections that you see in fully funded plans.




ITA with all of this.

My dh's company has done this for years. They are willing to cover me--for a surcharge. As a result, he and our dd's are covered under his plan, and I remain covered through my own employer.


Jill

Luvnlifelady
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Posted: 12/6/2012 10:06:43 PM
How would they know if you turned down insurance offered at your job?

Quite a few women I know work part-time (like me) and aren't even offered benefits. That would be the same for SAHMs as well.

I have a friend whose DH works overseas. She's about 50. She got her own private insurance policy at $600/mo. It has a $3,000 deductible so basically it's just catastrophic. She has no chronic medical conditions that I know of.

This insurance thing is killing everyone.



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Posted: 12/6/2012 10:36:14 PM
Yep it's true


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ScrampingMomof3
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Posted: 12/6/2012 10:45:59 PM
This is not an unusual practice.

It has been a while since I filled out insurance forms, but if your spouse is going to carry you in his/her insurance policy, isn't one of the bits of info they ask for place of employment?


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Posted: 12/6/2012 10:57:40 PM
My company charges a per-pay-period 'fee' to cover a spouse who has the opportunity to obtain insurance through his/her employer - I think it's 50/paycheck (paid bi-weekly, so that's 1300/yr). They've done this for the past few years.

For that reason, we go with DH's insurance. It's slightly less than mine even without the fee, even though they are both BCBS (his company is much larger and gets a little better negotiated rate as a result). His dental and vision are much cheaper than mine, too.

Re: self-funded insurance - DH's company used to have a self-funded option that was administered by UHC and we had that until they dropped it in CY2011. It had fewer exclusions and was a little more flexible on providers. The company's reason for dropping that option was that partially due to the changes happening in healthcare insurance etc. and partially (mostly) due to the liability of the company when healthcare costs exceed premiums etc. (when it's not self-funded, the carrier has to suck up the excess on a bad year, more or less - at least that's how I remember it being explained).



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Posted: 12/6/2012 10:58:04 PM
DH and I have always been on our own plans with our individual employers. Most often DH's employer has covered him for free. I have the kids on my plan since I make most of the medical decisions for them.


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Posted: 12/7/2012 12:40:30 AM
I've never heard of this. We pay an wxtra $70 a month for me since spouse + kids is more than just + kids, but no surchage. DH works for a hospital health system so as long as we use their facilities the insurance is way better than the cheap stuff my district went to.


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Posted: 12/7/2012 1:13:36 AM

How would they know if you turned down insurance offered at your job?


Where I worked the husband/wife, had to sign a form stating that their spouse had not declined insurance, or insurance was not offered at their place of employment, otherwise they were charged a surcharge, or dropped from the spouses coverage.

If they found out you used the insurance and didn't comply with their rules you had to repay any benefits you used, or be terminated.


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Posted: 12/7/2012 4:20:56 AM
Thanks all. Guess I'm sunk on that on.

scrapApea
StuckOnPeas

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Posted: 12/7/2012 4:20:57 AM
Thanks all. Guess I'm sunk on that on.

TerriG
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Posted: 12/7/2012 6:41:30 AM
My employer recently did this and also tripled the rates for just me and DD, plus what we would have paid through DH's employer for him. Although it's been better coverage for our family, it would have worked out that I would actually OWE them money on the paychecks over long school breaks. Seriously? You want me to go into debt to work for you? So far, we've been able to jump over to DH's insurance, and I was allowed to get on it too. We'll have to re-evaluate if his company chooses to do the same thing and decide where it's better for us to put DD.




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Nantini
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Posted: 12/7/2012 7:04:42 AM
Kelly, thanks for the clarification. It's hard to hear how something is said in written word. A few others have said its because employers are greedy and I took your post to mean the same thing.



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Posted: 12/7/2012 8:08:05 AM

It is because they contribute part of the total cost of the insurance.

Where I work, and everywhere I have ever worked, the contribution to insurance was the same between a single, single +1 or family. That is why the cost to the employee increases as you expand coverage.




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Posted: 12/7/2012 8:47:05 AM
Maybe he misunderstood. Ask him to bring home the memo.


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Posted: 12/7/2012 8:47:12 AM
I can't help you with the insurance but as for the credit card charges, sign up for online access to your credit card account if you haven't already. I have disputed charges online without ever speaking to "Albert" who is probably extremely well educated but his accent is a killer.

Did your company cancel your account, or they they just take the charges off the account? If they didn't cancel it, you should still have online access to that number and can see the progress of your complaint.


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Posted: 12/7/2012 9:16:56 AM
Yes. Agree this is becoming more common practice. Each year I am asked to complete contract stating I'm not working and/or I am not offered insurance through my employment. I have actually NOT accepted a part time job because of it. My husbands employer requires a $150 surcharge per month to stay on my husbands insurance if my employer paid even $00.01 of the seriously crappy accident type policy offered. It didn't matter if the coverage was capped at $1000 in benefits per year. Totally not a comprehensive medical policy, apples and oranges, we would still have the surcharge. The part time gig i have has no benefits and that is one of the things is a must for me!


michellejeanne
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Posted: 12/7/2012 11:45:05 AM
We've had the same for my husbands 20 years at his company. I worked for a very small company (3-8 employees) that could not get decent group rates, so she didn't offer it. Was happy because my DH's plan was great. Still is, relatively, although we pay much more than we used to.

Of course now I have a boatload of medications (without which I would not be able to move, much less work), and that's the thing that scares me about going back to work. I'm afraid that I'd pretty much be working to pay my insurance and medications when I want a job to add to retirement and college funds.

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Posted: 12/7/2012 12:16:42 PM
I agree with Kelly

This is happening more and more as employers are looking for ways to find ways to cut the rise in rates.


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Posted: 12/7/2012 12:56:42 PM
I'm afraid that I'd pretty much be working to pay my insurance

========================================

My husband works with people who are working for the insurance for their families. Spouse has a job that does not offer insurance, so they work there. Their pay is not enough to cover the insurance, so they write a check to the employer to cover the money they owe. I hope you do not end up in the same situation.



likescarrots
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Posted: 12/7/2012 3:40:11 PM
This is not a 'new' practice. When I worked for my previous employer 7 years ago this happened to one of my coworkers (it was her husbands work, not ours, that kicked her off their plan, the company is a well known drugstore chain).

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Posted: 12/7/2012 4:25:17 PM
Not quite the same, but we had to provide proof to our insurance of not only our marriage, but proof that we were still married and filing taxes jointly (income was blacked out, but social security numbers were not). We also had to provide copies of our kids' birth certificates.

I was not happy. Everything they asked for could open us up for possible identity theft if a crooked or careless employee handling were handling it.

But it was provide it or be kicked off. And they didn't give us a lot of time to get the necessary documents. I think they were trying to find excuses to dump dependents.


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Posted: 12/7/2012 5:26:32 PM
The first time I heard of this was in 2007-2008 at a friend's university job. Theirs was a $50 monthly surcharge.

I just left a company with 40,000 U.S. employees that's doing this now. If you want coverage for a spouse, you have to somehow document that they don't have any other coverage available to them. No documentation, you pay the surcharge. What a hassle.
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sierra821
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Posted: 12/7/2012 10:35:38 PM
My husbands employer had the working spouse additional premium, then they dropped that charge and cover everyone for the same fee whether I can get insurance at work or not. We pay $115 every 2 weeks for insurance.


Mom to Alex (16) Hunter (11) and Hailey (5)


sierra821
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Posted: 12/7/2012 10:35:56 PM
My husbands employer had the working spouse additional premium, then they dropped that charge and cover everyone for the same fee whether I can get insurance at work or not. We pay $115 every 2 weeks for insurance.


Mom to Alex (16) Hunter (11) and Hailey (5)


sierra821
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Posted: 12/7/2012 10:36:01 PM
My husbands employer had the working spouse additional premium, then they dropped that charge and cover everyone for the same fee whether I can get insurance at work or not. We pay $115 every 2 weeks for insurance.


Mom to Alex (16) Hunter (11) and Hailey (5)


momofkandn
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Posted: 12/7/2012 11:37:22 PM

But it was provide it or be kicked off. And they didn't give us a lot of time to get the necessary documents. I think they were trying to find excuses to dump dependents.


Many companies are going to full out dependent verification now. And the reason is that dependent fraud is very prevalent. No one ever checked in the past who you put on your policy. Especially if you work for a large company. I have a client that dropped 35% of their dependents when they insisted on verification. They found that people were putting all kinds of relations on their plan like nieces and nephews, keeping ex spouses on the plan and significant others that didn't qualify as a spouse. One employee even had his mother on his family plan. No one noticed that one because he said she was his spouse. She was much older than him but that's not a red flag by itself. Companies also put in verification to make sure employees aren't trying to pass off over aged dependents which is pretty common too.

Premiums are mostly decided by claims. It's really important for companies to make sure that only eligible dependents are covered so that claims are minimized as much as possible.

So yes, they are trying to drop dependents. But they really are only going after ineligible dependents.
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