Scrambling for a new health insurance plan!
September 25, 2016 11:23 AM Subscribe
Received a notice in the mail yesterday that our group health plan at work will be terminated on FRIDAY. The letter was issued on 9/20/2016. As far as I know, we are still employed by our company. Shouldn't we have been given a TEENY bit more notice? I don't even know where to start with this. Hope me, wise ones!
Response by poster: (Apologies, I'm a bit frazzled.) I'm asking if we are entitled to more time to find insurance. Should the employer pay for next month's coverage since he didn't give us 30 days notice? Not looking to take legal action. I'm in CA.
posted by pea_shoot at 11:32 AM on September 25, 2016
posted by pea_shoot at 11:32 AM on September 25, 2016
In that case, yes, they are required to give you 30 days notice. Make sure this was the first communication they had with you.
That said though, practically, I would focus my efforts on getting the new plan up and running. It may not be worth your time and energy to fight this, but your cost/benefit calculation may be different from mine.
posted by brainmouse at 11:36 AM on September 25, 2016 [1 favorite]
That said though, practically, I would focus my efforts on getting the new plan up and running. It may not be worth your time and energy to fight this, but your cost/benefit calculation may be different from mine.
posted by brainmouse at 11:36 AM on September 25, 2016 [1 favorite]
Okay, so you got notified strictly as an employee? You are not the benefits administrator for your company?
If that is correct, this is largely your company's problem to solve. In California, ceasing to offer benefits abruptly would be pretty sketch and get your company in a good deal of trouble. If you are the benefits administrator for your company, you get to rip a stip off somebody on Monday if you don't already have a panicked voicemail telling you to disregard the notice you received.
But I have received these letters in the past simply because our group policy was changed slightly, but in the ponderous old insurance software that meant cancelling plan A, which generates an automated notification, and enabling plan B, the notification for which you will probably receive on Monday.
You probably do not need to go get new insurance this weekend.
posted by Lyn Never at 11:42 AM on September 25, 2016 [3 favorites]
If that is correct, this is largely your company's problem to solve. In California, ceasing to offer benefits abruptly would be pretty sketch and get your company in a good deal of trouble. If you are the benefits administrator for your company, you get to rip a stip off somebody on Monday if you don't already have a panicked voicemail telling you to disregard the notice you received.
But I have received these letters in the past simply because our group policy was changed slightly, but in the ponderous old insurance software that meant cancelling plan A, which generates an automated notification, and enabling plan B, the notification for which you will probably receive on Monday.
You probably do not need to go get new insurance this weekend.
posted by Lyn Never at 11:42 AM on September 25, 2016 [3 favorites]
Note: Friday is the last day of the month. That would be a normal time to make a policy change, and Q4 is when most companies start their yearly fiddling with benefits administration.
posted by Lyn Never at 11:44 AM on September 25, 2016
posted by Lyn Never at 11:44 AM on September 25, 2016
And if you do need to get your own insurance, losing coverage through an employer is a qualifying event for the Affordale Care Act, so you would go to healthcare.gov, choose individual plans, enter your state, and go from there.
posted by MsMolly at 11:45 AM on September 25, 2016 [2 favorites]
posted by MsMolly at 11:45 AM on September 25, 2016 [2 favorites]
CoveredCA is the California exchange. Every time I've had to check just in case, their rates have been comparable to the okay-but-not-spectacular rates through my employer (for the exact same plans).
posted by Lyn Never at 11:51 AM on September 25, 2016 [1 favorite]
posted by Lyn Never at 11:51 AM on September 25, 2016 [1 favorite]
i recently got a letter like this and it was the situation mentioned above: the end of a specific plan at work, with a new slightly more expensive one starting the very next day. have you received any communications about rate increases?
posted by poffin boffin at 11:55 AM on September 25, 2016
posted by poffin boffin at 11:55 AM on September 25, 2016
Response by poster: I am not the benefits coordinator. Last time they changed our health care plans, they provided us with packets of information so we could sign up for new plans. This change is sudden and even management is in the dark.
posted by pea_shoot at 11:58 AM on September 25, 2016
posted by pea_shoot at 11:58 AM on September 25, 2016
Also are you 100% sure that the letter says coverage is terminated immediately? This is about the time of year when most plans send out letters if a particular plan is going to be discontinued on January 1st.
posted by MsMolly at 12:15 PM on September 25, 2016
posted by MsMolly at 12:15 PM on September 25, 2016
Response by poster: Sorry to threadsit, but the letter says "cancellation due to Group Termination". There has been no mention of any changes to our policy.
I should have mentioned this in the original post: Our owner was in the process of selling the company, but that fell through. We are still his employees. Just...soon-to-be uninsured employees? There is a lack of communication here that is incredibly frustrating.
I was trying not to give too many details since this is a public forum. I think our HR person jumped ship.
(He also cancelled direct deposit without telling anyone. That was fun!)
posted by pea_shoot at 12:41 PM on September 25, 2016
I should have mentioned this in the original post: Our owner was in the process of selling the company, but that fell through. We are still his employees. Just...soon-to-be uninsured employees? There is a lack of communication here that is incredibly frustrating.
I was trying not to give too many details since this is a public forum. I think our HR person jumped ship.
(He also cancelled direct deposit without telling anyone. That was fun!)
posted by pea_shoot at 12:41 PM on September 25, 2016
It's sounds like your company is running out of cash. My guess is that they didn't pay for benefit coverage. I suspect that you are in danger of not being paid.
posted by saradarlin at 12:57 PM on September 25, 2016 [27 favorites]
posted by saradarlin at 12:57 PM on September 25, 2016 [27 favorites]
Best answer: The federal regulator for employee group health insurance is the Employee Benefit Security Administration, part of the Department of Labor. They specifically have a Participant Assistance and Outreach Program to help explain and troubleshoot issues like this. I would get in touch with them either immediately via the web site or Monday morning by phone.
posted by Jahaza at 12:58 PM on September 25, 2016 [7 favorites]
posted by Jahaza at 12:58 PM on September 25, 2016 [7 favorites]
Pretty sure saradarlin has it. This reminds me of things that happened at a previous employer just before it sank.
posted by infinitewindow at 1:08 PM on September 25, 2016 [3 favorites]
posted by infinitewindow at 1:08 PM on September 25, 2016 [3 favorites]
I agree that your employer is close to going under, I would start looking for a new job ASAP. I would also lean into your employer about the health coverage and demand that he find a way to fix this (but, I wouldn't be overly optimistic that he could before October 1st).
If you don't have conditions that will require medical care in October/November, you might feel better knowing that your Individual Mandate under the ACA will only apply if you go more than two full months without coverage in the calendar year (the "short gap exemption"). Therefore, if you're relatively healthy (and confident in your ability to stay healthy and accident free for the duration) you don't need to scramble to find an Exchange plan or other replacement coverage in the next week.
Even if you don't get coverage before December of this year, your penalty for going 3 months without coverage may be cheaper than paying for coverage for the rest of the year (because the penalty is pro-rated by month).
If you, or your family, does need insurance, then looking into the exchanges at the same time as getting on your bosses case to get you the compensation that you are owed is a good idea.
posted by sparklemotion at 1:40 PM on September 25, 2016 [1 favorite]
If you don't have conditions that will require medical care in October/November, you might feel better knowing that your Individual Mandate under the ACA will only apply if you go more than two full months without coverage in the calendar year (the "short gap exemption"). Therefore, if you're relatively healthy (and confident in your ability to stay healthy and accident free for the duration) you don't need to scramble to find an Exchange plan or other replacement coverage in the next week.
Even if you don't get coverage before December of this year, your penalty for going 3 months without coverage may be cheaper than paying for coverage for the rest of the year (because the penalty is pro-rated by month).
If you, or your family, does need insurance, then looking into the exchanges at the same time as getting on your bosses case to get you the compensation that you are owed is a good idea.
posted by sparklemotion at 1:40 PM on September 25, 2016 [1 favorite]
Consider contacting the California Department of Insurance as well.
posted by holgate at 1:41 PM on September 25, 2016
posted by holgate at 1:41 PM on September 25, 2016
This happened to me a few times just before my company went under (they failed to pay premiums several times, begged forgiveness and caught up, and then missed payments again). In the cancellation letters we got, there was information for how to start COBRA. Does your letter have this? If so, then you would know you could always activate cobra retroactively in case of something catastrophic.
posted by Tandem Affinity at 7:59 PM on September 25, 2016 [1 favorite]
posted by Tandem Affinity at 7:59 PM on September 25, 2016 [1 favorite]
Best answer: 1 of 2 things has happened: either your company's group policy was cancelled due to lack of payment, or they switched insurance carriers during a renewal period (which would mean your company's coverage through the old carrier would be cancelled). Since you say even management is in the dark and you clearly haven't signed up for insurance through a new carrier, the first option seems most likely.
Important thing to know: COBRA continuation only applies as long as the company's group policy is active. If it's been cancelled and never gets reinstated, that will not be an option for you.
Most carriers, including Covered California (the state exchange), consider involuntary loss of group coverage a qualifying event that allows you to enroll outside the usual annual enrollment period. They'll give you 30 days from the date your previous coverage ended to enroll, and when you do enroll, coverage will be retroactive to the date your company coverage ended. So you don't have to scramble to find coverage before Friday--you've got 30 days from Friday, and if you needed medical care during that period, you'd be able to submit a claim after you're enrolled. I don't recommend waiting until the very last day to enroll, though--they can be a little slow to process enrollments, especially this time of year.
You may be able to request an exception/extension to that 30-day window by writing a letter explaining your situation. The request for an exception may or may not be granted.
posted by rhiannonstone at 10:13 PM on September 25, 2016 [2 favorites]
Important thing to know: COBRA continuation only applies as long as the company's group policy is active. If it's been cancelled and never gets reinstated, that will not be an option for you.
Most carriers, including Covered California (the state exchange), consider involuntary loss of group coverage a qualifying event that allows you to enroll outside the usual annual enrollment period. They'll give you 30 days from the date your previous coverage ended to enroll, and when you do enroll, coverage will be retroactive to the date your company coverage ended. So you don't have to scramble to find coverage before Friday--you've got 30 days from Friday, and if you needed medical care during that period, you'd be able to submit a claim after you're enrolled. I don't recommend waiting until the very last day to enroll, though--they can be a little slow to process enrollments, especially this time of year.
You may be able to request an exception/extension to that 30-day window by writing a letter explaining your situation. The request for an exception may or may not be granted.
posted by rhiannonstone at 10:13 PM on September 25, 2016 [2 favorites]
(Sorry this is happening to you!!)
posted by wenestvedt at 3:25 AM on September 26, 2016 [1 favorite]
posted by wenestvedt at 3:25 AM on September 26, 2016 [1 favorite]
Response by poster: I checked in with management this morning. Our boss did NOT switch insurance plans and our coverage ends on September 30th.
posted by pea_shoot at 11:20 AM on September 26, 2016
posted by pea_shoot at 11:20 AM on September 26, 2016
Boo.
How many job applications did you submit today? Because unless management provides you with a plan to get you insurance starting Saturday, you'll be taking what I imagine to be a major pay cut.
I am stubborn enough (and have enough of a savings cushion) that I would likely have submitted notice today saying that I wouldn't be in after September 30th unless something else was in place. The smart thing to do is to get something else lined up before you walk, but you really need to be getting ready to walk.
posted by sparklemotion at 3:27 PM on September 26, 2016 [1 favorite]
How many job applications did you submit today? Because unless management provides you with a plan to get you insurance starting Saturday, you'll be taking what I imagine to be a major pay cut.
I am stubborn enough (and have enough of a savings cushion) that I would likely have submitted notice today saying that I wouldn't be in after September 30th unless something else was in place. The smart thing to do is to get something else lined up before you walk, but you really need to be getting ready to walk.
posted by sparklemotion at 3:27 PM on September 26, 2016 [1 favorite]
Response by poster: Just learned that new management is taking over on Saturday. A little heads up would have been nice! I believe we will have new health insurance plans set up for November 1st. Hopefully, nothing will happen health-wise in October.
Thanks for the responses!
posted by pea_shoot at 7:54 PM on September 27, 2016 [1 favorite]
Thanks for the responses!
posted by pea_shoot at 7:54 PM on September 27, 2016 [1 favorite]
pea_shoot, I've worked at a company where ownership changed hands, and there was no lapse at all in health insurance. Your situation still screams "get a new job before it's too late" to me. Best of luck!
posted by infinitewindow at 9:31 PM on September 27, 2016 [1 favorite]
posted by infinitewindow at 9:31 PM on September 27, 2016 [1 favorite]
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posted by brainmouse at 11:29 AM on September 25, 2016