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Healthy Insurance Question

Posted on 9/10/15 at 9:25 am
Posted by FootballNostradamus
Member since Nov 2009
20509 posts
Posted on 9/10/15 at 9:25 am
Two questions for any who could help.

1. I started with a new company in June, and I'm just now finding out that the paperwork I filed with the cute (and apparently incompetent) HR chick was never submitted to our healthcare provider and as such I haven't been enrolled in a healthcare plan since around May when I left my previous job. I've been told that Obama's "you get a tax fine if you don't have healthcare" is a bit like the redlight ticket camera thing where they can't truly enforce it. Is this true or am I way off on that?

2. Why are there "open enrollment" periods for health insurance? Why can't you just start whenever you want to? Doesn't make much sense to me.
Posted by Pilot Tiger
North Carolina
Member since Nov 2005
73146 posts
Posted on 9/10/15 at 10:54 am to
quote:

. Why are there "open enrollment" periods for health insurance? Why can't you just start whenever you want to? Doesn't make much sense to me.
to prevent people from going uninsured all year and then when they get ill or have an accident buy insurance to pay for their medical bills. Insurance only works if you are paying for it while healthy.
Posted by BACONisMEATcandy
Member since Dec 2007
46643 posts
Posted on 9/10/15 at 11:07 am to
If you are due a refund they will absolutely enforce the penalty
Posted by LSUGUMBO
Shreveport, LA
Member since Sep 2005
8526 posts
Posted on 9/10/15 at 11:08 am to
quote:

I've been told that Obama's "you get a tax fine if you don't have healthcare" is a bit like the redlight ticket camera thing where they can't truly enforce it. Is this true or am I way off on that?


I've been told that they cannot levy a separate penalty for being uninsured, that they can only take away from any money you might be owed in a refund/overpayment. I don't remember all the specifics, but I remember thinking that if you just ended up owing money every year, you'd never get penalized.
Posted by lsupride87
Member since Dec 2007
95458 posts
Posted on 9/10/15 at 11:16 am to
quote:

to prevent people from going uninsured all year and then when they get ill or have an accident buy insurance to pay for their medical bills. Insurance only works if you are paying for it while healthy.
You got part of this correct. Prior to 2014, there was open enrollment year round on most plans; HOWEVER, pre-existing conditions were often not covered due to this. Starting in 2014, excluding pre-existing conditions became illegal; therefore, health insurance companies now have Open enrollment peroids to protect themselves
Posted by LSUFanHouston
NOLA
Member since Jul 2009
37115 posts
Posted on 9/10/15 at 11:47 am to
quote:

I've been told that Obama's "you get a tax fine if you don't have healthcare" is a bit like the redlight ticket camera thing where they can't truly enforce it. Is this true or am I way off on that?


The IRS is not allowed to use their collection powers (liens, levys, garnishments, etc) to collect the penalty. However, if you EVER are owed a refund, federal or state, they can keep some of it to apply to the penalty. Even if that refund is years later.

quote:

Why are there "open enrollment" periods for health insurance? Why can't you just start whenever you want to? Doesn't make much sense to me.


Because otherwise, on the way to the hospital, I'd call and sign up. However, when you start a new job, you are allowed to enroll no matter what time of year it is (you may have a waiting period for eligibility).
Posted by FootballNostradamus
Member since Nov 2009
20509 posts
Posted on 9/10/15 at 12:51 pm to
quote:

The IRS is not allowed to use their collection powers (liens, levys, garnishments, etc) to collect the penalty. However, if you EVER are owed a refund, federal or state, they can keep some of it to apply to the penalty. Even if that refund is years later.


Hmmmm, I purposefully don't withold much so as not to have a refund. Is there a limit on the amount of years they have to claim this?

quote:

Because otherwise, on the way to the hospital, I'd call and sign up. However, when you start a new job, you are allowed to enroll no matter what time of year it is (you may have a waiting period for eligibility).


Yea I understand that concept. I had insurance for about 3/4s of the year and genuinely just forgot to enroll. I was about to go to get my eye exam and was unsure of my vision plan so I called up Cigna only to findout I hadn't enrolled. I figured I would just backpay all the premiums I missed, but they said this wouldn't work.

Kinda annoying. I know they have these things in place to keep people from jobbing the system, but I was in the middle of a cross-country move, starting a new job and just genuinely forgot.
Posted by lsupride87
Member since Dec 2007
95458 posts
Posted on 9/10/15 at 1:06 pm to
quote:

Kinda annoying. I know they have these things in place to keep people from jobbing the system, but I was in the middle of a cross-country move, starting a new job and just genuinely forgot.
Any possible qualifying events happen to you since your 31 day enrollment period closed? If so you can enroll now:

1.Change in legal marital status, including marriage, death of a spouse, divorce, legal separation and annulment.
2. A change in the number of dependents, including birth, death, adoption, and placement for adoption.
3. A change in employment status of the employee, or the employee’s or retiree’s spouse or dependent, including termination or commencement of employment, a strike or lockout, a commencement of or return from an unpaid leave of absence, a change in worksite, and a change in working conditions (including changing between part-time and full-time or hourly and salary) of the employee, the employee’s or retiree’s spouse or dependent which results in a change in benefits they receive under a cafeteria plan or health or dental plan.*
4. A dependent ceasing to satisfy eligibility requirements for coverage due to attainment of age, student status, marital status, or other similar circumstances.*
5. A change in place of residence of the employee, retiree or their spouse or dependent and the current carrier is not available.
6. Significant cost or coverage changes (including coverage curtailment and the addition of a benefit package).
7. Family Medical Leave Act (FMLA) leave.
8. Judgments, decrees or orders.
9. A change in coverage of a spouse or dependent under another employer’s plan.
10. Open enrollment under the plan of another employer.
11. Health Insurance Portability and Accountability Act (HIPPA) special enrollment rights for new dependents and in the case of loss of other insurance coverage.
12. A COBRA-qualifying event.
13. Loss of coverage under the group health plan of a governmental or educational institution (a state’s children’s health insurance program, medical care program of an Indian tribal government, state health benefits risk pool, or foreign government group health plan).
14. Entitlement to Medicare or Medicaid.
15. Any other situations in which the group health or dental plan is required by the applicable federal or state law to allow a change in coverage.
Posted by FootballNostradamus
Member since Nov 2009
20509 posts
Posted on 9/10/15 at 1:19 pm to
quote:

lsupride87


Looked through the other exceptions and I don't qualify for any.
Posted by lsupride87
Member since Dec 2007
95458 posts
Posted on 9/10/15 at 1:35 pm to
quote:

Looked through the other exceptions and I don't qualify for any.
Next choice is to get a cheap short term major medical plan until enrollment opens, or go to Obamacare until then
Posted by Golfer
Member since Nov 2005
75052 posts
Posted on 9/10/15 at 1:49 pm to
quote:

Looked through the other exceptions and I don't qualify for any.



I'm pretty sure your employer can speak with their insurance rep to add you...even if delayed. Provided there's records that you filled out the information when it was supposed to be completed.
Posted by GeauxBlonde
Member since Feb 2013
170 posts
Posted on 9/10/15 at 1:57 pm to
quote:

I'm pretty sure your employer can speak with their insurance rep to add you...even if delayed. Provided there's records that you filled out the information when it was supposed to be completed.


^this. HR should easily be able to talk to the provider and backdate your coverage start date. Have they been taking premiums from your paychecks all this time too?
Posted by FootballNostradamus
Member since Nov 2009
20509 posts
Posted on 9/10/15 at 2:31 pm to
quote:

HR should easily be able to talk to the provider and backdate your coverage start date. Have they been taking premiums from your paychecks all this time too?


I called Cigna and they said our policy was to file solely based on the exceptions mentioned above. I might speak with my HR directly, though, and see what they can do. The Cigna punk might have just not wanted to fillout the extra paperwork haha.
Posted by GeauxBlonde
Member since Feb 2013
170 posts
Posted on 9/10/15 at 2:50 pm to
Yes, your HR dept would need to make that request to them directly, not you. If HR forgot to send in your info the blame is on them and thus they should be able to backdate your coverage.

I've had people forget to add their newborns to their health insurance and have been able to add them and backdate coverage to 6 months prior. So your situation should be an easy fix.
Posted by Creamer
louisiana
Member since Jul 2010
2817 posts
Posted on 9/10/15 at 3:11 pm to
I had the same thing happen with my company and hr took care of it. It was with Cigna as well.
Posted by Iowa Golfer
Heaven
Member since Dec 2013
10230 posts
Posted on 9/10/15 at 8:07 pm to
You have coverage. Likely your employer carries employee benefit liability for just such an event. If you had medical bills, you'd need to collect here. If you were subject to an IRS fine, I'd make the employer get something from the carrier that writes the EBL.

Now the cute girl probably doesn't know any of this, but I bet the owner, or risk manager if it's larger employer certainly does. If they don't know this stuff, they have no business owning a business, being a controller/risk manager or being an employer.
Posted by Bestbank Tiger
Premium Member
Member since Jan 2005
71174 posts
Posted on 9/12/15 at 4:11 pm to
You may want to check into a sharing ministry. You can use them for the remainder of this year. (You can also keep them as secondary insurance in the future).
Posted by Rust Cohle
Baton rouge
Member since Mar 2014
1947 posts
Posted on 9/12/15 at 7:14 pm to
Yea you should through a fit if needed to get their mistake fixed
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