Health Insurance (Options)

[sam_gordon]

Trying to figure out what our options are. I have an email in to my HR person and DS is supposed to ask his...

Backstory
Myself, DW, DS, and DD(#2) are all on my company's insurance via a family rate. DS accepted a "professional" job that offers insurance (yay!)
DS is getting married in the beginning of November. His fiancé is currently on her mom's insurance.
My health insurance "term" is Sept 1 - August 31.

We're trying to figure out what would be "best" (relative term I know).

DS has three plans he can choose from his company, but they all have a decent sized premiums. So, our thought is he stays on ours (doesn't cost us any extra because of the family plan) and he can pocket that money. BUT, what do we do in September? I'm ASSUMING he can't join his company's health care then because it would be the middle of the plan year.

OK, I can sign him back up for mine. BUT, I think I read somewhere once he gets married, he can't be on my insurance? I might have that wrong though.

I'm ASSUMING his (and his fiancé's) work plans don't start until January 1. So, unless he joins his new company's plan now, will there be a "gap" of time when he can't be covered on my plan (either Sept 1 - Dec 31 or Wedding - Dec 31)? Not a huge deal, but not ideal.

Other information/suggestions?

I think our ideal is he stays on my plan even after the wedding, then sign up for either his or his (then) wife's plan to start Jan 1. Whenever that starts, drop him from my coverage (but there's no financial benefit, so really no rush). Is that doable?

 

[soccerdad72]

I'm no expert in this area, but I believe that your son's marriage would be a 'qualifying event' which would allow for him to join his employer's health plan mid-year.

 

[Mommb]

If your son starts a new job in the middle of the year, he should be able to get onto his company's insurance before the end of the year.

Per the Affordable Care Act, your son can stay on your plan until he turns 26. I don't think being married makes a difference, but obviously you should check with your employer or insurance plan.

If you drop your son from your coverage, he should be able to sign up for coverage with his employer even if it's the middle of the year. Losing coverage is typically a "qualifying event" that allows mid-year changes. So is marriage.

Unless the job is in a different location where your insurance won't provide sufficient coverage, I'd say you should keep your son on your insurance at no additional cost until he turns 26, at which point he should go on his company's insurance. However, if his wife-to-be turns 26 before he does, or if covering her is a significant cost to her family, he may want to cover both of them once they are married.

 

[sam_gordon]

If your son starts a new job in the middle of the year, he should be able to get onto his company's insurance before the end of the year.

He's starting the job this month. I thought most people only had a couple of weeks when starting a new job to sign up for their insurance.

Per the Affordable Care Act, your son can stay on your plan until he turns 26. I don't think being married makes a difference, but obviously you should check with your employer or insurance plan.

Yea, trying to iron out if he can still be on our plan if he's married.

If you drop your son from your coverage, he should be able to sign up for coverage with his employer even if it's the middle of the year. Losing coverage is typically a "qualifying event" that allows mid-year changes. So is marriage.

That could help too.

Unless the job is in a different location where your insurance won't provide sufficient coverage, I'd say you should keep your son on your insurance at no additional cost until he turns 26, at which point he should go on his company's insurance. However, if his wife-to-be turns 26 before he does, or if covering her is a significant cost to her family, he may want to cover both of them once they are married.

That would come down to whether he's allowed to be on my insurance if he's married. Job is in the same state I'm in.

 

[Mackenzie Click-Mickelson]

If your son is under the age of 26 he can remain even after marriage under the ACA act, there are exceptions such as being on military plans like TriCare which a marriage would remove coverage.

Typically a marriage is considered a life event but the application of that being used after open enrollment has closed is typically used when the spouse is being added to the person's company plan not for what you would be describing but they could certainly look at what their each respective company policies are.

 

[DizneyFamof4]

Per HealthCare.gov
Generally, you can join and stay on a parent’s job-based plan until you turn 26 even if you:

• Got married
• Have or adopt a child
• Start or leave school
• Live in or out of your parent’s home
• Aren’t claimed as a tax dependent
• Turn down an offer of job-based coverage

 

[Skippy918]

What you can do is renew him for next year and then when he gets married him and his wife can switch to his employer or her employers plan. There would be no gap. You just have to enroll within 30 days of the event. Have they looked at high deductible plans with an HSA?
When does he turn 26?

 

[sam_gordon]

What you can do is renew him for next year and then when he gets married him and his wife can switch to his employer or her employers plan. There would be no gap. You just have to enroll within 30 days of the event. Have they looked at high deductible plans with an HSA?
When does he turn 26?

So getting married would allow him to join his plan mid year? I can see how a marriage would allow a spouse to join, but wasn't sure about the employee joining.

He sent us the list of options he has for medical coverage, no HDCP. Premiums between the lowest and highest plan is <$10/paycheck.

He doesn't turn 26 until 2029.

 

[Skippy918]

So getting married would allow him to join his plan mid year? I can see how a marriage would allow a spouse to join, but wasn't sure about the employee joining.

He sent us the list of options he has for medical coverage, no HDCP. Premiums between the lowest and highest plan is <$10/paycheck.

He doesn't turn 26 until 2029.

Yes. Marriage is a qualifying event and you can change insurances within those 30 days. The new plan would be effectively dated as the date of the wedding.

 

[Mackenzie Click-Mickelson]

What you can do is renew him for next year and then when he gets married him and his wife can switch to his employer or her employers plan. There would be no gap. You just have to enroll within 30 days of the event. Have they looked at high deductible plans with an HSA?
When does he turn 26?

Yes. Marriage is a qualifying event and you can change insurances within those 30 days. The new plan would be effectively dated as the date of the wedding.

The life event would allow the OP to drop their son, the life event would allow the wife for example to join the now husband's company's plan or vice versa. The question would be if the company considered a person who declined enrollment upon start of employment can qualify as a life event due to marriage to then join the company's healthcare outside of open enrollment. There may be company policies that allow for this but I'm not seeing anything set up for the Market that it would be a qualifying event to add themselves to their company's healthcare plan due to marriage to then add them and their spouse.

The issue here is that neither the son nor their fiancée are covered under their company sponsored plan of their own, both are presently being covered under their parent's plans. It's an easy question to answer if that were the case (one of them being on their own company's plan) where after marriage the life event rule would kick in and they could add the new spouse to whichever.

 

[Skippy918]

If OP drops their son, that in and of itself should be a qualifying event. Your son should check with his benefits department. They can give him all the information.

 

[Mackenzie Click-Mickelson]

If OP drops their son, that in and of itself should be a qualifying event. Your son should check with his benefits department. They can give him all the information.

But that's not the issue. The OP can drop the son because they had a life changing event, it doesn't answer the issue the son themselves has for coverage for himself. Obviously yes the son is the one who should be doing all this asking of his company because company policy may dictate different things than the Marketplace rules are.

 

[lanejudy]

If OP drops their son, that in and of itself should be a qualifying event. Your son should check with his benefits department. They can give him all the information.

Loss of coverage may or may not be a qualifying event for the son’s employer policy. He needs to confirm that with his HR office.

I’m a strong proponent of letting young adults BE adults — that is being fully self supportive including their insurance (assuming it is a benefit offered by the employer).

 

[tvguy]

I’m a strong proponent of letting young adults BE adults — that is being fully self supportive including their insurance (assuming it is a benefit offered by the employer).

Well, there can be situations where it makes more financial sense for PARENTS for their kids to remain on their parents memberships, etc. My kids are 39 and 35 and they are still on our family gym membership because we are grandfathered back to a rate from 2005. If we drop them, the rate for just my wife and I would be double what we pay for the grandfathered family plan.
And a former coworker just turned 40 and is still on his parents cell phone plan for the same reason, they are Grandfathered into rates that don't exist anymore. He has been out of his parents household for 20 years.

 

[lanejudy]

Well, there can be situations where it makes more financial sense for PARENTS for their kids to remain on their parents memberships, etc. My kids are 39 and 35 and they are still on our family gym membership because we are grandfathered back to a rate from 2005. If we drop them, the rate for just my wife and I would be double what we pay for the grandfathered family plan.

Do your kids use the gym membership? I seem to recall from other posts that at least 1 is married and not living nearby, and the other had been in Europe for a while. Your situation sounds like you keep a family membership for your financial benefit, not for theirs. Not really what I was talking about.

 

[tvguy]

Do your kids use the gym membership? I seem to recall from other posts that at least 1 is married and not living nearby, and the other had been in Europe for a while. Your situation sounds like you keep a family membership for your financial benefit, not for theirs. Not really what I was talking about.

Yes, my financial benefit, which is what I was talking about.

 

[focusondisney]

Loss of coverage may or may not be a qualifying event for the son’s employer policy. He needs to confirm that with his HR office.

I’m a strong proponent of letting young adults BE adults — that is being fully self supportive including their insurance (assuming it is a benefit offered by the employer).

Yep, me too.

 

[Skippy918]

Kids are lucky these days they can stay on a parent’s insurance till they are 26. I was dropped literally the day I graduated college. A friend was dropped when they graduated high school.

 

[barkley]

Loss of coverage may or may not be a qualifying event for the son’s employer policy. He needs to confirm that with his HR office.

another vote for looking at the son's employer's policy but a couple of other things to perhaps look into-

is the fiancee working for someone that offer's insurance? if so what are her options/employer rules on qualifying event?

do either work for an employer that w/proof of insurance for self through an outside plan the employer pays their traditional share of cost to the employee? I mention this b/c dh had an employer who did this.

you can't run the numbers until you have ALL the options to play with.


LASTLY but perhaps most importantly-do either the son/fiance have any specialists they don't want to lose/they REALY don't want to lose their PCP? if that's the case they need to-

review any potential plan to see if their doctors/specialists/meds are covered AND ask the doctor/specialists if they are listed if they will be PERMITTED to remain a patient under the new insurance (some groups/practices limit the number of patients per plan and a change can mean finding someone new).