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re: Rush on pre-existing ...it's not insurance, it's welfare
Posted on 5/3/17 at 1:36 pm to roadGator
Posted on 5/3/17 at 1:36 pm to roadGator
in employer insurance (that's large group and small group) large group like mine is self insured, small group is underwritten meaning it's insurance, self insurance means your employer is merely paying your claims. when you are hired you have a thirty day waiting period that's typically done to facilitate the payroll deduction aspect of your premiums (in small group) or your employee contribution in large group at that time all pre existing conditions are covered, they can not be excluded. if for some reason you were to cancel your coverage and let it lapse for more than 90 days, then pre-existing conditions can be uncovered for up to 18 months for adults (16 or over) and six months for minors. you can skip coverage but you are allowed a chance to enroll during the next open enrollment period but if you haven't maintained some form of valid coverage since the past open enrollment period the 90 day lapse rule applies.
in other words you have coverage through your wife's plan you decide you want it through your employer instead, you got no problems, you just didn't want the coverage cause it's expensive and you didn't plan on getting sick then that condition will be excluded doesn't mean they won't take you it's simply means claims related to that specific pre-existing condition will not be paid.
in other words you have coverage through your wife's plan you decide you want it through your employer instead, you got no problems, you just didn't want the coverage cause it's expensive and you didn't plan on getting sick then that condition will be excluded doesn't mean they won't take you it's simply means claims related to that specific pre-existing condition will not be paid.
Posted on 5/3/17 at 1:37 pm to tedmarkuson
Um, I've been in the health insurance industry since 1996.
Also, I served a brief time in underwriting. Not everyone with a PEC was denied coverage. It depends on what it was and actually what the market was doing at the time.
Also, I served a brief time in underwriting. Not everyone with a PEC was denied coverage. It depends on what it was and actually what the market was doing at the time.
This post was edited on 5/3/17 at 1:38 pm
Posted on 5/3/17 at 1:41 pm to tedmarkuson
quote:
large group like mine is self insured
Ahh.. you are bringing up 25 year old memories of calling up blue cross every single morning, finding out what claims were paid and making a bank transfer to cover those claims at the physicians group I worked for then. Fun times.
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