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deeprig9
Georgia Fan
Member since Sep 2012
35143 posts

Change of Employers-Loss of Health Insurance for non-Qualified Spouse
In brief-

New employer coverage will not cover spouse because spouse is eligible for insurance through their employer.

Spouse benefit administrator says provide all documentation of the loss of coverage to qualify for the Qualifying Life Event, then the new coverage is in effect the first day of month *following* all docs received/processed.

With last day of existing benefits being on the last calendar day of the month, Is this guaranteed to be a month lapse in coverage for the spouse?


BallsEleven
LSU Fan
Member since Mar 2019
651 posts

re: Change of Employers-Loss of Health Insurance for non-Qualified Spouse
Sounds like its dependent on when you get your paperwork in, not when your coverage drops.

Could be wrong though.
quote:

*following* all docs received/processed.


deeprig9
Georgia Fan
Member since Sep 2012
35143 posts

re: Change of Employers-Loss of Health Insurance for non-Qualified Spouse
Can't get required docs until after termination of old job. They won't send notice of future termination of benefits. Which is last day of month.i took this all the way to hr vp. They won't provide this until after termination.
This post was edited on 9/11 at 5:01 pm


eng08
LSU Fan
Member since Jan 2013
3906 posts

re: Change of Employers-Loss of Health Insurance for non-Qualified Spouse
If super worried buy cobra for the month.



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BallsEleven
LSU Fan
Member since Mar 2019
651 posts

re: Change of Employers-Loss of Health Insurance for non-Qualified Spouse
Then yeah you’ll have a month gap. Cobra probably wouldn’t be worth it for a month. I had the same issue when I separated from the military last year. We had a month gap between tricare running out and the wife’s insurance kicking in. We rolled the dice.


eng08
LSU Fan
Member since Jan 2013
3906 posts

re: Change of Employers-Loss of Health Insurance for non-Qualified Spouse
You can also buy cobra retroactively


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deeprig9
Georgia Fan
Member since Sep 2012
35143 posts

re: Change of Employers-Loss of Health Insurance for non-Qualified Spouse
Isn't there some kind of law or regulation where if you do it nice and smooth, there is no lapse?


My current employer (Fortune 10 company) HR says "oh yeah it should definitely be retro, that's normal" but they won't give me the docs.

My wife's small employer benefits admin (ADP) says no, nothing is retro, you get your shite on the first of the month after your paperworks is filed.

But my Fortune 10 company can't give me that paperwork until AFTER my shite expires.

I'm really really really close to just fricking suing somebody, everybody.

I was hoping coming to this board would have some people that actually have in depth knowledge on the subject.



Puffoluffagus
LSU Fan
Savannah, GA
Member since Feb 2009
4054 posts

re: Change of Employers-Loss of Health Insurance for non-Qualified Spouse
I really can't believe that your new employer can't give you the paperwork to fill out and submit, especially if you already have a contact signed with them/it's a done deal.

Most would allow you to assign an effective date.

However my experience is that most employers have a 30 day wait period regardless from the start of your job...i.e. you don't get your benefits from day 1. In those cases, cobra is your only option(which as mentioned above can be applied retroactively).


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TigerGrl73
LSU Fan
Nola
Member since Jan 2004
20441 posts

re: Change of Employers-Loss of Health Insurance for non-Qualified Spouse
quote:

Isn't there some kind of law or regulation where if you do it nice and smooth, there is no lapse?

Your option is Cobra. You can hold off until her coverage becomes effective but if something does come up in the meantime, you get Cobra which will be retroactive.
This post was edited on 9/12 at 7:00 am


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LSUFanHouston
LSU Fan
NOLA
Member since Jul 2009
16964 posts

re: Change of Employers-Loss of Health Insurance for non-Qualified Spouse
I don't understand how wife's current company isn't forced to start coverage the day after a QLE. Even if it takes a few days for the paperwork to kick in, and they have to retro the coverage.

I had something a bit similar happen to me a few years ago. Our firm changed insurance providers. Something happened, I'm not privy to what it was, but the end result was on the first day of coverage with the new provider, the paperwork wasn't done. So we had no coverage for about 10 days. When the paperwork was finally done, the coverage was retro to the first day.

During those 10 days, we were told if we needed medical care, to see if the provider could delay billing a bit, and if they could not, to just pay it out of pocket and the insurance company would reimburse us later on.

All of this thread is further reason why we need to decouple health insurance and your job.


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Golfer
LSU Fan
Member since Nov 2005
72900 posts

re: Change of Employers-Loss of Health Insurance for non-Qualified Spouse
quote:

My wife's small employer benefits admin (ADP) says no, nothing is retro, you get your shite on the first of the month after your paperworks is filed.


That’s incorrect. Qualifying Events allow the policy to take effect immediately.

If your wife had a kid (qualifying event) on the 5th the month, the kid's insurability starts on the 5th. Not on the 1st of the following month.

You may be billed/processed for two months on the 1st of the following month. But the insurability is effective day 1 with a qualifying event declaration completed.


TigerGrl73
LSU Fan
Nola
Member since Jan 2004
20441 posts

re: Change of Employers-Loss of Health Insurance for non-Qualified Spouse
quote:

Qualifying Events allow the policy to take effect immediately.


Not all QLEs. Adding dependents (birth, adoption, etc), yes. While some employers may have plans that will take effect immediately no matter the QLE, not all do, and it's not unusual.





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