Health Insurance/New Job Question

March 12, 2013 5:35 AM

Can a new employer wait 7 months to start health insurance?

We live in Kansas if that affects the answers to this question.

My wife currently works at a local hospital and I am self-employed. She carries the health insurance for both of us and our two children.

She has been offered a job at a local school district, but was told yesterday that her health insurance would not start until October 1st of this year even though they want her to start working in two weeks.

We do not want to have to pay for our insurance on our own for the next 6-7 months and with two boys (1 year old and an almost 4 year old) I refuse to go without insurance.

Can they make us wait that long? I thought that HIPPA prevented stuff like this happening.

If they can do this, what are our options? Does anyone have any recommendations for affordable family coverage?

posted by Broken Ankle to work & money (10 answers total)

Yes, the new employer can do that.

Has your wife asked why? And if an exception can be made since you have evidence of creditable coverage?

If worse comes to worse, by leaving the hospital job's group plan, she would (likely) be offered COBRA, which is expensive, but would bridge the gap until the school job's coverage starts.
posted by FergieBelle at 5:41 AM on March 12

It seems likely that, as a school district, they run on school-year agreements with their insurance provider. The question would be do they really have no option for mid-year hires, or is it just expensive or a lot of paperwork or just trying to get away with it because they can. She should probably push back on that and see what happens, if the two of you decide the insurance situation is a dealbreaker.

It is possible that your wife's current employer is a participant in a healthcare system that might make her continuation of coverage less blindingly expensive than most COBRA coverage. She would probably need to figure that out on the sly, though.
posted by Lyn Never at 5:50 AM on March 12 [1 favorite]

It is often possible to negotiate these kinds of benefits.
posted by jeather at 6:25 AM on March 12 [1 favorite]

Well a couple of things could be going on here.

1. They have a 6 month waiting period written into their health insurance plan. I've seen it one other time.
2. Their plan year begins 10/1 and the person she is talking to doesn't realize that new hires can enroll when they begin and don't have to wait for the plan year.
3. Maybe she isn't going to be working full time until the new school year and so isn't eligible until 10/1.
4. Their plan has no ability to add people mid-year. I've never seen this before but I'm not familiar with any gov't plans.

You will only know by asking, "Why?" If the answer you receive isn't satisfactory, ask to see a plan document that states the waiting periods and enrollment periods or ask to speak with the actual benefits person.
posted by magnetsphere at 7:09 AM on March 12

HIPAA doesn't cover this issue. (The Affordable Care Act will apply, starting in 2014, when the 90-day limit on waiting periods goes into effect.) I second magnetsphere's advice that the best way to get some sort of answer is to ask to see the plan document that states explicitly what the waiting period and eligibility requirements are.
posted by scody at 8:42 AM on March 12

Thank you everyone for the quick answers.

My wife is too timid to actually push the issue or ask too many questions and I do not feel it is appropriate for me to push her on this.

The good news is that I have learned that I can buy insurance for the boys and I as an employer that is more affordable than being on her plan in the fall.
posted by Broken Ankle at 9:13 AM on March 12

It's generally legal for them to do whatever they want WRT benefits. That said, your wife should really push back - is it totally impossible, or just inconvenient for the school?
posted by radioamy at 11:05 AM on March 12

When I switched jobs (I'm a computer programmer working for a private company) my current employer had a 6 month waiting period too. I was single at the time so I just went 6 months without insurance, which was very unwise in retrospect. Now that I have a wife and kids I would have to save up enough to pay for 6 months of COBRA coverage before switching jobs... which at our current rates would be an astounding $1,907.10/month for our family plan.
posted by exhilaration at 1:59 PM on March 12

That's a strange waiting period. Usually it's 30 or 60 or 90 days. Is there a union involved? She really could ask for clarification - "just wanted to double check, what benefits, how much, and when?" Without being pushy.
posted by dpx.mfx at 4:52 PM on March 12

There are policies out there for these situations, called short-term, temporary, bridge, or gap insurance plans. They may have high deductibles. Talk to an independent agent and get some quotes versus your wife's COBRA.

This is the US. There are a lot of gaps out there.
posted by dhartung at 4:21 AM on March 13 [1 favorite]