Never got kicked out of health plan from old job. Should I do anything?

January 8, 2019 10:19 PM

Found out recently I'm still part of a health plan from an old job I quit over a year ago. Now I'm covered under two separate plans. Should I do anything about it? (btw I'm in the USA)

Briefly:

November 2017 - Working full time at old job. Old job announces new health insurance plan for 2018. Signed up during open enrollment period

December 2017 - Quit this old job to work at new job

January 2018 - Got new ID cards from both old job insurance plan and new job insurance plan. Discarded old health insurance plan IDs. told doctor about new insurance everything is smooth so far

October 2018 - Laid off from new job, signed up for new plan on state exchange

November 2018 - Got my ID cards from state exchange plan, had some doctor visits, told them about my state exchange plan.

December 2018 - To my surprise, received statement of benefits from old job insurance plan saying my November doctor visits were processed. Signed into website of this plan and realized I never been kicked out and my visits were paid for.

So I'm guessing what happened was some typo occurred and I never was cut out from the old job health plan. Then after I got laid off, when I told my doctor's office about my new state exchange plan they somehow found I was still covered under my old job plan and they billed them as my primary insurer (without notifying me).

Also I just logged in to my old job plan's website yesterday and I'm still active for 2019.

I'm leaning towards just doing nothing and just ride it out on two plans but telling the doctor to use the state exchange plan as my primary insurer (don't even know if that matters),

I'm wondering what the legality of all this is and if my old job or insurance company (I'm not sure who is at fault here) could go after me to pay back the premiums when they find out in the future.

posted by sammich to Work & Money (7 answers total)

Best answer: Something like this happened to me.

I was briefly enrolled to Plan 1 with a previous employer. I had no idea Plan 1 had never fully disenrolled me due to a database error. In fact, I hadn't paid premiums on it since 2009.

Years later, at a new company and enrolled under a different insurer (Plan 2), I went to the occasional provider appointment and paid my premiums faithfully for years. In 2016, I developed a major medical condition with ongoing treatment that was billed to Plan 2 at a rack rate of just over 100K per month. Awesome.

Plan 2, a couple of months after seeing these enormous bills come in and hoping that there was something, anything, that could disqualify me as an insured so they wouldn't have to pay, contracted with a third party company that compares lists of active insureds between different insurers. This third party company found me still insured under Plan 1 and notified Plan 2.

Plan 2 immediately started sending me letters informing me I had other primary insurance and they would no longer be paying my bills.

My medical providers started billing me directly. It took months to fix. I had pending bills of about 600K and counting by the time it was sorted out, and it's only because the providers were understanding that this didn't end up in collections. This was very stressful during a period when I was dealing with health stuff, and Plan 2 was zero help at all because fixing it meant them paying.

In short, insurance companies will look to find any reason to disqualify you. Having two primary insurances is reason for disqualification. If they find reason to disqualify you, it is very stressful to fix.
posted by mochapickle at 2:07 AM on January 9, 2019 [23 favorites]

Seconding mochapickle. Do not ignore this.
posted by spitbull at 3:38 AM on January 9, 2019 [3 favorites]

Best answer: Insurance companies (depending on your local laws ianal) can retroactively cancel insurance once they realize you haven't been paying premiums and in all likelihood sue you to recoup what they've paid for claims since you left your previous employer; since the 1st insurer has no agreement with nor even really knows 2nd insurer, it'll be on your shoulders to straighten it out, there's no incentive for #1 to talk to #2, because *you're* the one getting the benefits so *you're* the one on the hook. They may even put the pressure on your medical care provider by taking money back from them, which means you may lose access to medical care -- not just due to being uninsured or underinsured, but being unable to schedule appointments because of outstanding bills.

Something else to consider: group insurance plans usually have an 'employer contribution' portion of the insurance, so it is likely that your old employer has been paying something, but not the entirety, of your insurance premiums since you left there; sure, it's due to their own oversight, but that doesn't mean they won't cause problems since they've got skin in the game, and by 'skin' I mean a amount of money larger than you have access to. If your old employer is *really* bad at paperwork, they've been paying your full premium (just writing a check to insurance when the bill arrives) which means that they may feel like you owe them money, since they've been paying your part of the insurance premium all this time.

These are just two of many, many bad scenarios when you're benefiting, even unintentionally, from one or more companies without paying them for the service: you need to nip it in the bud ASAP before the numbers get too large to manage or someone else catches it and takes action that puts you at a serious disadvantage.
posted by AzraelBrown at 4:30 AM on January 9, 2019 [5 favorites]

Good advice above. This is something you want to handle sooner rather than later. Good luck.
posted by kabong the wiser at 5:19 AM on January 9, 2019

Best answer: If you're getting any subsidies on your state-exchange plan, which are generally based on not having access to affordable insurance through work, having other insurance could likely also screw up those subsidies.
posted by lazuli at 5:34 AM on January 9, 2019 [1 favorite]

Yeah, no good can come of this. I have seen patients stuck with thousands of dollars of bills when the old insurance dis a retroactive cancellation. I don’t know how that can even be legal, but apparently it is.
posted by SLC Mom at 11:35 AM on January 9, 2019

Response by poster: I was under the wrong headed assumption that my old job was still paying for my premiums though I don't have evidence of that. But I'll start with notifying them first. Thanks everyone for the insights!
posted by sammich at 1:25 AM on January 10, 2019