Just call me Forgetful Jones.
November 15, 2009 10:20 AM Subscribe
I missed the date to continue my state health insurance. Now my only option is to pay for the super-high-end one until 2011. Do I have any chance of fixing this?
I've been working in my awesome office since 2005. I started as a "classified" (state civil service) employee doing administrative work, then transitioned into a half-time position as a graduate assistant (different union) while finishing my master's degree. In September, I transitioned back into full-time work, which is a different position but still technically "classified." During this entire time, I've only filled out one set of tax paperwork (except when my relationship status changed) and have had the same financial coordinator/boss. I've even sat at the same desk through three very different jobs.
So the other day when I went to the doctor, I got held up at the desk. They said my insurance had expired on October 31, and that they couldn't find me anywhere in the system. Eventually I just got fed up, and my clinician and I agreed to just go in and do the appointment and figure it out later.
When I got to work, I checked in with my boss, and she got in touch with the benefits people.
Turns out that when I started my "new job" on Sept. 1, I had 30 days to enroll in a plan. Then I could have done open enrollment for next year during October, but although I considered it, I didn't end up switching.
This is doubly weird because they didn't consider me a new employee for tax purposes. Or, I should add, for vacation purposes -- I only have the leftover hours from my previous stint as a classified employee, which also kinda stinks.
So all I can do now is enroll in the "standard plan." Luckily, that gives me my choice of everything, but unluckily it's the most expensive plan and has a 180-day pre-existing condition clause for everything except pregnancy. And I'm not eligible to change until next year's open enrollment, which still won't go into effect until 2011. (Geez. 2011.)
And... in looking at the cost, it's $150 more expensive for just me, and $488 for a "family plan" (adding a partner or child). So I guess we won't be doing that. I should add that this extra $150 would be reeeeeally nice to have when I start paying my loans in January. (My boyfriend has insurance, but it's way less useful than my state plan, and I may not qualify as a domestic partner.)
I'm just so royally peeved that this perfect storm of forgetfulness between me and my boss ended up like this. Apparently there was one line in my appointment letter that said I had to sign up, but that was it. No reminder from anyone, and no note saying "Oh, watch out, you're going to lose your insurance at the end of the month." I mean, it's not their responsibility to do so, but I never even got anything to say that my 30-day window was over.
Is there anything I can do? I am assuming from prior interactions that HR's rules (which are the state rules) are pretty hard and fast, but they've also treated me like a continuing employee for the whole time. Plus most situations don't involve someone who goes back and forth like this.
Yes, that's right. I AM a special snowflake.
Are there any sort of things I could say to help my case? Could I get fired and rehired? I'm in Wisconsin.
I've been working in my awesome office since 2005. I started as a "classified" (state civil service) employee doing administrative work, then transitioned into a half-time position as a graduate assistant (different union) while finishing my master's degree. In September, I transitioned back into full-time work, which is a different position but still technically "classified." During this entire time, I've only filled out one set of tax paperwork (except when my relationship status changed) and have had the same financial coordinator/boss. I've even sat at the same desk through three very different jobs.
So the other day when I went to the doctor, I got held up at the desk. They said my insurance had expired on October 31, and that they couldn't find me anywhere in the system. Eventually I just got fed up, and my clinician and I agreed to just go in and do the appointment and figure it out later.
When I got to work, I checked in with my boss, and she got in touch with the benefits people.
Turns out that when I started my "new job" on Sept. 1, I had 30 days to enroll in a plan. Then I could have done open enrollment for next year during October, but although I considered it, I didn't end up switching.
This is doubly weird because they didn't consider me a new employee for tax purposes. Or, I should add, for vacation purposes -- I only have the leftover hours from my previous stint as a classified employee, which also kinda stinks.
So all I can do now is enroll in the "standard plan." Luckily, that gives me my choice of everything, but unluckily it's the most expensive plan and has a 180-day pre-existing condition clause for everything except pregnancy. And I'm not eligible to change until next year's open enrollment, which still won't go into effect until 2011. (Geez. 2011.)
And... in looking at the cost, it's $150 more expensive for just me, and $488 for a "family plan" (adding a partner or child). So I guess we won't be doing that. I should add that this extra $150 would be reeeeeally nice to have when I start paying my loans in January. (My boyfriend has insurance, but it's way less useful than my state plan, and I may not qualify as a domestic partner.)
I'm just so royally peeved that this perfect storm of forgetfulness between me and my boss ended up like this. Apparently there was one line in my appointment letter that said I had to sign up, but that was it. No reminder from anyone, and no note saying "Oh, watch out, you're going to lose your insurance at the end of the month." I mean, it's not their responsibility to do so, but I never even got anything to say that my 30-day window was over.
Is there anything I can do? I am assuming from prior interactions that HR's rules (which are the state rules) are pretty hard and fast, but they've also treated me like a continuing employee for the whole time. Plus most situations don't involve someone who goes back and forth like this.
Yes, that's right. I AM a special snowflake.
Are there any sort of things I could say to help my case? Could I get fired and rehired? I'm in Wisconsin.
I'm assuming you are working for the UW? My experience in general (as an LTE for another state agency, a UW grad student PA, and also formerly as a UW unclassified staff) is that there's not a lot of flexibility in any of these policies. To make matters worse, the people who are in positions to guide you through this (like your supervisor) often don't get the ins and outs of how this all works. At the other state agency I saw a supervisor misinform another LTE - who really needed the benefits (I was an undergrad at the time and on my parents' insurance). The result was she didn't get the benefits she thought she was getting, and the supervisor (who had given me the same wrong advice, which luckily I did not need) denied any share of responsibility.
If you want to try to investigate it more I would start by going not to your boss, but to your department administrator. They are the ones who know how to work the system, if in fact it can be done. And if anyone has ever gotten a super special override they'll know what the circumstances were. If you were still a grad student you could also try the dean's office of the graduate school, but it sounds like that no longer applies.
Good luck...I know how tricky it can be to be part of the state system.
posted by handful of rain at 1:18 PM on November 15, 2009
If you want to try to investigate it more I would start by going not to your boss, but to your department administrator. They are the ones who know how to work the system, if in fact it can be done. And if anyone has ever gotten a super special override they'll know what the circumstances were. If you were still a grad student you could also try the dean's office of the graduate school, but it sounds like that no longer applies.
Good luck...I know how tricky it can be to be part of the state system.
posted by handful of rain at 1:18 PM on November 15, 2009
Do I read right that you've got a union job? Maybe they can help you understand your options. (Or at the very least, help you get the vacation you ought to be due if you are indeed considered a new employee...)
posted by EmilyClimbs at 5:29 PM on November 15, 2009
posted by EmilyClimbs at 5:29 PM on November 15, 2009
Unfortunately, it's usually pretty hard to get around missing the window to sign up for employer-based coverage. As I understand it the regulations around when you can sign up for employer coverage are governed by the IRS (because it's a tax-free benefit), and employers might not have a lot of wiggle room to give exceptions even if the reasons that you missed signing up are reasonable/understandable. It sounds like in your case the switch from part-time to full-time coverage triggered a "qualifying event" and for whatever reason that particular qualifying event means that your job automatically dropped you from your previously-selected health insurance. (I don't think that most employers would have things set up that way, so it's worth double-checking with HR about why exactly you were dropped from your previous coverage, and whether it's possible that was a mistake rather than your employer's written policy when employees move from part- to full-time.)
A couple of other thoughts, which may or may not be helpful:
*Remember that the $150 in additional premiums is with pre-tax dollars, so it's not quite as bad. If your marginal tax rate is something like 25% [for people earning between $34,000 and $89,000 in 2009], then what you're actually losing out of your paycheck is more like $112. Still sucks, but not quite as badly as losing $150.
*Make sure you ask HR about whether and how the pre-existing condition exclusion applies to you specifically under the new, more expensive plan; since you've had group health insurance for a long time before you signed up--and the HR department has proof of it--you should not be subject to any exclusion period (or at most one month for the month of October where you had a break in group coverage).
*With respect to partner benefits (whether that's you going on your boyfriend's insurance or him coming onto yours): be aware that while many employers offer this fringe benefit, its treatment for federal tax purposes is not the same as for married spouses. Unless something has recently changed, the entire employer contribution to covering your partner--which sometimes runs into the thousands of dollars--is taxable to you, and that's something that should be factored in when you're deciding whether to both be insured on the same policy, now or in the future.
*You can sign up for whatever employer-offered plan you want before open enrollment happens next year if you have a qualifying event. This usually includes getting married, having a child, or adopting.
posted by iminurmefi at 8:29 AM on November 16, 2009
A couple of other thoughts, which may or may not be helpful:
*Remember that the $150 in additional premiums is with pre-tax dollars, so it's not quite as bad. If your marginal tax rate is something like 25% [for people earning between $34,000 and $89,000 in 2009], then what you're actually losing out of your paycheck is more like $112. Still sucks, but not quite as badly as losing $150.
*Make sure you ask HR about whether and how the pre-existing condition exclusion applies to you specifically under the new, more expensive plan; since you've had group health insurance for a long time before you signed up--and the HR department has proof of it--you should not be subject to any exclusion period (or at most one month for the month of October where you had a break in group coverage).
*With respect to partner benefits (whether that's you going on your boyfriend's insurance or him coming onto yours): be aware that while many employers offer this fringe benefit, its treatment for federal tax purposes is not the same as for married spouses. Unless something has recently changed, the entire employer contribution to covering your partner--which sometimes runs into the thousands of dollars--is taxable to you, and that's something that should be factored in when you're deciding whether to both be insured on the same policy, now or in the future.
*You can sign up for whatever employer-offered plan you want before open enrollment happens next year if you have a qualifying event. This usually includes getting married, having a child, or adopting.
posted by iminurmefi at 8:29 AM on November 16, 2009
This thread is closed to new comments.
posted by sulaine at 12:28 PM on November 15, 2009