HR Office says "No Health Insurance for You!"
October 28, 2008 11:51 PM   Subscribe

Can I really not get health insurance outside the standard enrollment period?

I am a new employee of a public university in Washington State. I missed submitting the health insurance paperwork before the deadline. Now I am being told by Human Resources that I have been entered into the default plan of basic health insurance for me and none for my family and there is absolutely nothing I or they can do about it. My family just has to go without health insurance until the next enrollment period or I have to buy it somewhere else, and by the way don't bother us again about this.

I ask those of you who have worked in HR or the health insurance field, is it really true that they cannot enroll my family? I know that the university hires people all year round, and I do not believe that they wait until the fall to get health insurance.

Any advice on how to deal with this? I am a little freaked out that my accident prone 9-year-old is uninsured right now!
posted by LarryC to Health & Fitness (14 answers total)
Everywhere I've ever worked (including at an insurance company -- where, in a stroke of grim irony, I found myself without any coverage at all because I blew the deadline), there is the annual open enrollment period for everyone, and the individual open enrollment period that only occurs when you're hired. This is just how group plans are administered, especially at organizations covering hundreds or even thousands of employees.

Having said that, is there a employee ombudsman at your workplace outside the HR dept. that you can consult with? There might be a way an exception can be made (a supervisor's supervisor finally interceded on my behalf when I'd screwed up my enrollment at my insurance co. job), but it's unlikely that HR will be forthcoming with it.
posted by scody at 12:38 AM on October 29, 2008

There are exceptions to the enrollment period for certain circumstances: marriage and birth of a child come to mind.
posted by zippy at 12:58 AM on October 29, 2008

You're lucky you even got health insurance for yourself--I'm surprised they even do that. Everywhere I've ever worked you had however many weeks after you were hired to sign up (or not) for insurance, and if you didn't do it then, you had to wait until open enrollment. The only exceptions are "qualifying life events": birth of a child, marriage, divorce, etc. If your family was previously covered and lost their coverage (say, your spouse had coverage through her job and lost it) then that might count as a qualifying life event.

It sucks, but this is yet another reason why healthcare should not be tied to employment.
posted by Violet Hour at 1:08 AM on October 29, 2008

Do you mean you missed the deadline because you were hired after the open-enrollment period was closed? Or that you were hired in time for this window, but missed filing it because of your own error (or your department, or whatever)? Those are two different situations, I believe.
posted by barnone at 1:11 AM on October 29, 2008

Sounds like your employer takes the insurance on a pre-tax basis, which is popular but limits the flexibility you have in your plan. In this situation, your employer, by law, can only allow changes to your insurance plan under specific circumstances. These include your first 30 days of employment, an annual "open enrollment" period during which anyone can make changes, and within 30 days of certain events such as marriage/divorce or the birth/death of an immediate family member.

Unfortunately it sounds like you missed your "new-hire" window; I don't think your company is trying to give you the run-around. There really isn't much they can do to help you at this point, so just find out when the next open enrollment period is and make the changes you need to make at that time.
posted by PFL at 4:18 AM on October 29, 2008

Meant to start with "Sounds like your employer takes your insurance contributions on a pre-tax basis..."
posted by PFL at 4:20 AM on October 29, 2008

Generally, yes, you're hosed until the next enrollment period comes around.
You can certainly buy some private coverage for your family on the open market to carry them through untill the next open enrollment. It's crazy expensive, though.
posted by Thorzdad at 5:03 AM on October 29, 2008

Yes, this is very common. Standard, I would say.

You said "I missed submitting the health insurance paperwork before the deadline." That's the key. You had a window in which to submit the paperwork as a new hire, and you missed that window. Once that window has closed, it can't be opened again unless one of the following happens:

+ Major life change (typically marriage, divorce, birth or adoption of a child, or spouse loses their job and needs to be added to your insurance)
+ Open enrollment period (in which all employees can make changes to their insurance status as desired).

That being said, if there is a valid reason outside your control that you missed it (perhaps someone forgot to communicate the deadline to you or you were not supplied with the correct paperwork?) you might be able to appeal. Some insurers in some states are pretty flexible about this. Others, not so much.

The Secretary of State's office for your state may be able to direct you to your state's insurance regulatory body if HR isn't being helpful.

But, yeah, if you missed submitting by the deadline, you will probably end up waiting until the next open enrollment period.
posted by anastasiav at 6:06 AM on October 29, 2008 [1 favorite]

Yes, this is standard practice. You are usually given something like 30 days after you are hired to enroll in health care benefits. This varies, of course. But if you missed your after-hire enrollment period than yes, you do have to wait until the next open enrollment period or until you have a life changing event (having a child, getting married, getting divorced) to change your benefits.

You might be in the middle of open enrollment now, though. Many places that I've worked at offer open enrollment between mid-October and November 30, for example, because benefits kick in on January 1, 2009. Check with HR that this isn't an open enrollment period before panicking. This information should be available on the HR website so you don't have to call them directly if you don't want to.

A glance at a few websites for state schools in Washington shows the following open enrollment periods:
Washington State University - October 27 - November 30
Western Washington University - October 27 - November 30
University of Washington - October 27 - November 30
This leads me to believe that you're in the middle of open enrollment at your job right now and should have no problem enrolling your family. This coverage doesn't kick in until January 1, 2009.
posted by k8lin at 7:47 AM on October 29, 2008

If all else fails, you might call your old school *today* and see whether you're still in the COBRA window.
posted by ROU_Xenophobe at 10:02 AM on October 29, 2008

If you're working at a public college or university in Washington state, then you're covered by state employee health insurance: the Public Employee Benefit Board. The statewide open enrollment period started on Monday (10/29) and runs through the end of next month. You can even change your insurance online w/out talking to your school's HR.

HOWEVER...this is for insurance changes starting January 2009.

I would guess that if HR told you that you'd been signed up for "basic health insurance," then you were registered for the Uniform Medical Plan. And yes, unfortunately, if you didn't get them the paperwork within their deadline, then your family can't be covered until January. (You can add family members during open enrollment.)

So go fill out your open enrollment forms NOW! (I don't know what to advise for family insurance between now & then.)

IANAHRProfessional, but I worked for a WA community college for 6 years. Oh, be sure to check your withholdings after the first of the year; when I added mr. epersonae after he changed jobs, they forgot to change my withholdings, and I ended up owing a bunch of cash because I hadn't noticed the difference.
posted by epersonae at 12:21 PM on October 29, 2008

Er, make that started on Monday (10/27).
posted by epersonae at 12:26 PM on October 29, 2008

Can I really not get health insurance outside the standard enrollment period?

As others have said, and to clarify, yes and no.

You can get insurance, and you were offered it. You failed to turn in the forms. That failure caused you to not have health insurance.
posted by gjc at 4:26 PM on October 29, 2008

You can certainly buy some private coverage for your family on the open market to carry them through untill the next open enrollment. It's crazy expensive, though.

Potentially not that bad, actually. Since you don't need to secure permanent coverage for them, a short-term policy could be appropriate if such a thing is offered in your state. When I looked into it in CA, the rates were less than equivalent permanent policies and the application process was ridiculously easy (like, you could have it active within a day or two). If you're really worried about accidents, that'd at least buy you peace of mind while you continue petitioning to get them into the group plan.

The important difference is that short-term = non-renewable. Up to 12 months max, and then you're out in the cold, so be sure you'll be able to get them into the group policy by then. Short-term policies are designed to fill coverage gaps, nothing more. Any insurance broker should be able to tell you what options exist in WA.

How long ago did you leave the old group policy? Because maybe you can still opt to put them back under it, using COBRA. I'd take an expensive group payment over an individual policy any day, if remotely eligible. The law offers a lot more protections to those in, or transferring from, group plans.
posted by nakedcodemonkey at 7:25 PM on October 29, 2008

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