Having double insurance coverage questions

[twinboysmom]

Hoping someone can offer some advice here. My DH works for a company that has been bought out my another company. We have decided to continue only our twin boys under the cobra insurance for 18 months. DH and I will go on the new company plan. I have just found out it will cost only an extra $100 per month to add the boys as well.

My questions are how does it work with having two insurance plans for our boys? We need the one we are going to cobra to remain as their primary. Our boys have autism and the new employer coverage is very unfriendly towards that diagnosis. Any words of wisdom would be appreciated. I have always had them covered but never with two plans.

 

[bigbabyblues]

I did insurance billing for a hospital for 14 years, and the companies I dealt with used the birthday rule--whichever parent's birthday came first in the calendar year had the primary policy. This may vary by state, I don't know. You may want to check with the H.R. Departments, the benefits person should be able to tell you.

 

[twinboysmom]

Both plans are through my husband.

 

[Lorelei Lee]

If I remember correctly you can't accept coverage under COBRA if you are covered under another plan.

My children are covered under my plan and under their father's plan. Birthday rule applies, making his policy primary. A few years ago, when I was changing jobs, I was eligible for COBRA benefits but they were not.

If I remember correctly you can keep COBRA benefits only for a specified time period.

And you can join an employer plan only during open enrollment or a life cycle event.

 

[bigbabyblues]

Both plans are through my husband.

Sorry, I missed that part. I don't think COBRA would be primary over anything else, if they can be on it and an active policy at the same time.

 

[Lorelei Lee]

http://en.wikipedia.org/wiki/Consolidated_Omnibus_Budget_Reconciliation_Act_of_1985

According to this you cannot be on a COBRA plan and another plan unless you meet certain requirements.

The other plan must either predate the plan you are COBRA-ing, or there are issues with pre-existing conditions being EXCLUDED.

That your new coverage isn't as good is NOT a work-around.

And if I recall correctly one of the components of Obamacare is that plans no longer exclude preexisting conditions.

I think you will have a tough time exercising COBRA rights just for your children, and if you do keep that plan, I don't think you can put them on your new plan.

You really need to talk to an expert before you make a mistake that could leave the kids uninsured.

 

[twinboysmom]

Well that makes sense. So my DH and I can join his new companies plan and then just keep cobra for the boys then. I should have realized we can't have both because of the stipulations with the cobra.

 

[twinboysmom]

http://en.wikipedia.org/wiki/Consolidated_Omnibus_Budget_Reconciliation_Act_of_1985

According to this you cannot be on a COBRA plan and another plan unless you meet certain requirements.

The other plan must either predate the plan you are COBRA-ing, or there are issues with pre-existing conditions being EXCLUDED.

That your new coverage isn't as good is NOT a work-around.

And if I recall correctly one of the components of Obamacare is that plans no longer exclude preexisting conditions.

I think you will have a tough time exercising COBRA rights just for your children, and if you do keep that plan, I don't think you can put them on your new plan.

You really need to talk to an expert before you make a mistake that could leave the kids uninsured.

It has zero to do with ore existing condition. It has to do with the fact that the new policy covers autism as a mental health condition only. That means zero therapy, no neurology work ups, only visits to a psychiatrist for counseling services. Pick spent two months on the phone and email with their hr director so I know what they do and do not cover. It was she who suggested we cobra my dh's original plan.

 

[Bren's Mom]

Have you been told what the premiums are for COBRA yet? Check that before you go further, they are likely to be VERY high.

 

[tvguy]

I think COBRA is an either/or situation for everyone. You can't split up the family. You ALL have to be on the same policy from your husbands employer, either the old one under COBRA or the new one.

 

[Lorelei Lee]

Seriously, you need expert advice that you are NOT going to find here on the DIS.

I am not in HR but I think the HR Director may not fully understand the rules. You need an insurance expert.

Did the HR director tell you that COBRA is only good for 18 months? In a year and a half you're going to be looking for new coverage.

You might be better off with private insurance, which doesn't come with all those rules and exclusions, and can be coordinated with the plan from your husband's new employer.

 

[twinboysmom]

I called and spoke with the COBRA respresentitive for my husbands company. It's a very large company and they are selling off two separate facilities. So yes, I know it's expensive but its by far less expensive than paying $200 per hour for my children's therapy and I for a MRI out of pocket. It was also this person who told me we could indeed cover only the children. We have carried cobra before and never were asked for any kind of proof that we needed it. Just signed the paperwork and sent the payment in.

Anyway, I was specifically looking for advice on having double coverage and the question was answered. Thanks to all who answered.

 

[bcla]

I think COBRA is an either/or situation for everyone. You can't split up the family. You ALL have to be on the same policy from your husbands employer, either the old one under COBRA or the new one.

COBRA has some interesting details. Splitting up a family for coverage is allowed. It might even be possible to keep COBRA for just the kids, but that may be state dependent.

The issue I would have would be how long you want to stay on COBRA. Eventually it's going to run out and it might not be possible to add the kids to the husband's insurance until open enrollment. There might be a loophole though. I know a newborn or newly adopted child can be added at any time. There are lots of odd rules. I asked about dropping insurance, and was told it wasn't possible until open enrollment unless my wife got a job with insurance. I was thinking it might be possible to add once the COBRA period ends.

 

[Kimberlyann11]

I think COBRA is an either/or situation for everyone. You can't split up the family. You ALL have to be on the same policy from your husbands employer, either the old one under COBRA or the new one.

You can chose to only have specific family members on COBRA if you wish.

 

[Lorelei Lee]

Did you ask this question when you spoke to your husband's company? They are giving you advice about taking COBRA benefits from them, not about accepting benefits from a new company in addition to the COBRA benefits.

Go ask them, not the. DIS.

 

[twinboysmom]

COBRA has some interesting details. Splitting up a family for coverage is allowed. It might even be possible to keep COBRA for just the kids, but that may be state dependent.

The issue I would have would be how long you want to stay on COBRA. Eventually it's going to run out and it might not be possible to add the kids to the husband's insurance until open enrollment. There might be a loophole though. I know a newborn or newly adopted child can be added at any time. There are lots of odd rules. I asked about dropping insurance, and was told it wasn't possible until open enrollment unless my wife got a job with insurance. I was thinking it might be possible to add once the COBRA period ends.

Thank you for this. I did ask the cobra rep from my husbands company and was told that we could do this. My husband also confirmed that we could add hem in open enrollment which we have plenty of time to do next year (and it's not in January) and that we can also enroll the boys is cobra end because losing health insurance is considered a status change.

Thanks to all who offered advice.