Health Insurance (Options)

[barkley]

But once graduated that car could not be included on the parents' policy unless the adult child lived at home,

rules may vary by state.

and they vary greatly. I had a detailed discussion with our insurance company b/c I couldn't figure out why they insisted our oldest stay on our policy post college graduation esp. since they KNEW via renter's insurance there was another address but they insisted that so long as our address was listed on the driver's license they considered it the driver's 'permanant address'. I then contacted the DOL who explained that their definition (per our state) is a fixed location where you officially reside and which serves as your point of contact for legal, administrative, and personal matters so since my oldest DOES NOT use their residence as their point of contact for legal or administrative purposes (strictly b/c of terrible postal services) our address is considered the default 'permanant address'. in our case it's beneficial b/c lower premium for oldest/multi-car discount for us result in lower premiums for us to pay.

 

[sam_gordon]

Re: the 1st paragraph:
That sounds like your son was asking for advice, not necessarily asking for a solution. So guiding your son through the decision making process might be what he's looking for. For example, "well, DS, here's some of the factors I would be considering if it were me..." Also, when your son said he didn't know which is the better option, that's a good opportunity to explain to him & his fiance what deductibles, coinsurance, and all that mean...might help them be able to compare apples to apples.

And if it puts your mind at ease, you know how much of this discussion I've told DS? So far, 0%. I try to understand/find out answers to questions I may be asked about a situation before I talk to someone about it.

Re: the 3rd paragraph:
It is not always an option when 1 spouse is laid off to be able to financially afford switching everyone's insurance to the other spouse's employer's health plan. For example:

• other spouse might not be working at a job that offers medical benefits
• other spouse might not be working at all
• other spouse's job might offer medical benefits, but they're so cost prohibitive (like $2000/month just for the insurance premium for a family of 4) that there's no way the family can afford it. This was our family's situation at one point several years ago.

True. But my point still stands... DS isn't getting married for nine months, so him getting on to his spouse's insurance (even if she had her own) isn't an option until then.

 

[kdonnel]

I had a detailed discussion with our insurance company

I also had a long detailed conversation with my auto insurance agent who insisted it was fine to continue insuring the car.

 

[TwoMisfits]

And if it puts your mind at ease, you know how much of this discussion I've told DS? So far, 0%. I try to understand/find out answers to questions I may be asked about a situation before I talk to someone about it.

True. But my point still stands... DS isn't getting married for nine months, so him getting on to his spouse's insurance (even if she had her own) isn't an option until then.

Okay, so he has a planned starting job with insurance. And thus he knows he should try to stick it out in that job til his marriage to ensure he stays covered...or he'll have to pick up COBRA for any interim months or see if he can hop back on your insurance if he can't stick it out.

You mentioned earlier being a backstop. Stepping in when there IS a problem is backstopping. Taking over and taking care of before son is even in a concerning state (I mean, why would he leave his job? Is it something already concerning?) is something more.

 

[tvguy]

and they vary greatly. I had a detailed discussion with our insurance company b/c I couldn't figure out why they insisted our oldest stay on our policy post college graduation esp. since they KNEW via renter's insurance there was another address but they insisted that so long as our address was listed on the driver's license they considered it the driver's 'permanant address'. I then contacted the DOL who explained that their definition (per our state) is a fixed location where you officially reside and which serves as your point of contact for legal, administrative, and personal matters so since my oldest DOES NOT use their residence as their point of contact for legal or administrative purposes (strictly b/c of terrible postal services) our address is considered the default 'permanant address'. in our case it's beneficial b/c lower premium for oldest/multi-car discount for us result in lower premiums for us to pay.

My daughter uses our address as her permanent address but lives 5,500 miles away in Germany. My insurance agent said as long as she isn't here more than 30 consecutive days she does not need to be on our auto insurance. AND she IS covered if she drives our car with our permission in that time frame. She has been here just 10 days in the last 17 months, and she just renewed her Driver's License but when she was here she never drove.

 

[Mackenzie Click-Mickelson]

FWIW y'all insurance agents do make mistakes, insurance agents do sometimes intentionally fib or pretend they didn't hear something. They are technically bound by their insurance license to do what they are supposed to do by their own insurance company(ies) they write with but they can do things wrong. When that happens where an agent did something wrong or told an insured something they shouldn't have or intentionally omitted information in order to maintain a client the client can suffer in the end, sometimes that leads to an E&O claim (errors and omissions) which is an insurance policy the agent has on themselves.

95% of my calls were from agents, trust me when they said "oh wait can you just forget I said that" when they accidentally said something that opened a can of worms my answer had to be "I'm sorry no I can't forget" because I was bound by compliance laws. Agents in general are great and trustworthy but having a conversation with them isn't always the gospel to abide by just because they said it.

Your first point of contact for information is to look at your policy back which is what your policy's booklet of information from what is covered and not covered to what your obligations are to what each and every definition is based on your state and product you are under. That is your legally binding document and what your agent tells you really isn't.

 

[lanejudy]

So it does or doesn't matter that DS said "I also know I’m still on your alls insurance but they offer some so I didn’t know what to try to look for or which is the better option". Does that qualify in your mind as asking for help?

Nope. You are still doing the research. HE needs to do the research, narrow down at least some options, and bring that info to the table (so to speak). Based on all the additional you’ve posted since the OP, you have zero to research other than maybe asking your wife to find out implications of 1) keeping him on her employer’s insurance vs removing him, and 2) when he can be dropped without penalty, 3) can he be re-added without penalty and when, etc. That’s the extent of YOUR research. Talk son through where he can find info (future HR, fiancé’s HR, state insurance website, school, etc.) But he and fiancé should do the primary info gathering and sort through at least preliminary options (“we’ve ruled out X because of ___reason.”). THEN you can help him talk out pros/cons of his options by explaining types of plans, coverages, premiums vs deductibles vs copays, limitations, unexpected health needs, etc.

 

[sam_gordon]

Okay, so he has a planned starting job with insurance. And thus he knows he should try to stick it out in that job til his marriage to ensure he stays covered...or he'll have to pick up COBRA for any interim months or see if he can hop back on your insurance if he can't stick it out.

You mentioned earlier being a backstop. Stepping in when there IS a problem is backstopping. Taking over and taking care of before son is even in a concerning state (I mean, why would he leave his job? Is it something already concerning?) is something more.

So I say I have said zero to my son about it (it's in the post you quoted), and yet you claim I'm "taking over and taking care of"? Care to explain how you made that leap?

Honestly, I started the thread asking what the options are, as in "he's allowed to do 'x'. Thinking "if DS asks me 'x', I could have an answer for him". Somehow that has become hindering him on learning how to work on a budget and "taking over and taking care of".

 

[TwoMisfits]

So I say I have said zero to my son about it (it's in the post you quoted), and yet you claim I'm "taking over and taking care of"? Care to explain how you made that leap?

Honestly, I started the thread asking what the options are, as in "he's allowed to do 'x'. Thinking "if DS asks me 'x', I could have an answer for him". Somehow that has become hindering him on learning how to work on a budget and "taking over and taking care of".

Actually, you also wrote your ideal...posters have decided to weigh in on whether that should be the ideal. If you have not included it, you may have gotten different answers...

"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?"

 

[VandVsmama]

If this were my kid and the kid had the following going on:

1. graduating college in May
2. starting new full time job after graduation. So let's say the job starts in June.
3. getting married in Nov

AND if my kid came to me and basically said, "So I know that I'm still on your health insurance but this new job comes with health insurance options and I have no idea how to pick the right now," my advice to my kid (your mileage may vary) would be the following:

• here's a quick overview of how health & dental insurance works...blah blah blah...explain what 'in network vs out of network' means. Explain what a deductible is + how it relates to seeing an in-network vs OON provider. Explain what coinsurance means & when that kicks in. Explain what individual vs family deductible vs OOP (out of pocket) max per year means.
• Explain to kid that most employers give you more than 1 health plan to choose from.
• Explain to kid how to compare the different health plans. This means comparing not only how much $$ per paycheck or per month the premium costs you, but what the indiv/family deductibles, coinsurance amounts, & annual OOP max amounts are for each health plan that the employer offers.
• Explain to kid that sometimes the cheapest plan might require you to see a PCP first for everything and then get a referral/prior auth in order to see a specialist. And I'd explain the pro's and con's of all that. It's not something that most 20-somethings think of since most of them are pretty healthy but you never know when life can throw you a curveball and you'll need to see a specialist for something.
• I'd show the kid what his/her current coverage is under our family's health plan. I'd walk the kid through all of the deductible & other info. AND I'd show the kid how much $$ gets deducted from our paychecks for that.
• Explain to kid what the difference is between a high deductible/HSA plan and a health plan that only has an FSA with it. With the former, any $$ deducted from your paycheck that's in the HSA account at end of the year can be rolled over to next year, but for FSA, it's use it or lose it.
• I'd suggest to kid that he/she review all of this with fiance + offer to explain to his/her fiance if fiance had questions.
• I'd check with my employer's HR department to confirm what the rules are to see if keeping kid on my health plan after he/she is married is even an option at all. If HR says 'No way we're going to allow that,' then that option is not even on the table and, therefore, once kid gets married, he/she will have to enroll in medical insurance through their employer or elsewhere on the open market. Usually employer-based plans are less expensive, but that's not always the case.
• I'd also confirm w/my employer's HR dept to confirm whether or not if kid had a baby/got pregnant, would the maternity care be covered. And I'd validate whether or not once baby is born, can the baby be added to my insurance plan. I'd assume that most insurance policies don't allow you to cover grandchildren.
• Explain to kid that usually once you officially start at a new full time job that includes medical benefits, you (new employee) have 30 days from your 1st day on the job to enroll in benefits. Would recommend to my kid that they ask about this prior to starting the job just so they can confirm that assumption. Trust but verify. ;-)
• Would recommend to my kid that he/she check w/HR dept at their new job to CONFIRM whether or not they can add medical coverage AFTER the 30 day mark post-1st-day-on-the-job if one gets married but you (the employee) do NOT sign up for medical insurance coverage w/in the 1st 30 days of employment. Trust but verify. Don't assume.
• Would recommend to my kid that he/she & future spouse discuss their options together as a couple and make a decision + let them know that I'm here for questions, suggestions, etc.

 

[VandVsmama]

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.

This is an incorrect assumption. The way it works at most places of employment is this:

• Let's say you start day 1 of new job on 6/1.
• By 6/30, you (new employee) have the option to enroll in medical, dental, vision, or any other benefits that the employer offers.
• HR adds you to the employer's health plan. Coverage usually is retroactive to your start date (6/1 in this example).
• Health plan's company mails you a member card. You usually get an email at your work email saying that you're enrolled.
• By 6/30, if you do nothing, no benefits for you. No medical coverage through that employer.
• Let's say then on 11/1, you get married.
• You notify employer that you got married. Call or email HR. Ask them what next steps are. They might ask for electronic copy of marriage certificate along with SSN of your spouse.
• 30 days later - 11/30 - this is your deadline to add spouse to your medical plan, dental plan, etc. at your work. If you do nothing, then only YOU would have medical (or other) coverage through your work (assuming you enrolled in a health plan by day 30 after starting the new job).
• Once HR adds your spouse to your health plan, they electronically notify health plan company, which adds the new member and you get new member cards in the mail. Coverage will be retroactive to whatever the add date is. So even though you won't get the member ID cards until later, spouse will be covered.
• Later on whenever your employer's annual benefits enrollment period occurs for the next calendar year (2027, let's say), you (the employee) have to enroll in coverage all over again just like you did when you first got hired.
• IF the annual benefits enrollment period for all employees is in the fall and that is BEFORE your wedding date, DO NOT WORRY because the wedding will be a triggering event and as long as you add the spouse to your coverage, then it will get added for the next calendar year also. If concerns about this, ask about it directly with employer's HR department.

 

[sam_gordon]

Nope. You are still doing the research. HE needs to do the research, narrow down at least some options, and bring that info to the table (so to speak). Based on all the additional you’ve posted since the OP, you have zero to research other than maybe asking your wife to find out implications of 1) keeping him on her employer’s insurance vs removing him, and 2) when he can be dropped without penalty, 3) can he be re-added without penalty and when, etc. That’s the extent of YOUR research. Talk son through where he can find info (future HR, fiancé’s HR, state insurance website, school, etc.) But he and fiancé should do the primary info gathering and sort through at least preliminary options (“we’ve ruled out X because of ___reason.”). THEN you can help him talk out pros/cons of his options by explaining types of plans, coverages, premiums vs deductibles vs copays, limitations, unexpected health needs, etc.

I'm curious. Did you read the thread?
1) I'm trying to do the research so *I* understand, so *IF* he comes to me with questions, I'll already have answers. Apparently, that's bad.
2) Why would I ask my wife about her employer's insurance? I never said we were on hers.
3) Yes, I'm trying to find out when he can be added to someone's insurance. Wasn't that in the OP? Not really bad information to have, is it?

 

[sam_gordon]

If this were my kid and the kid had the following going on:

1. graduating college in May
2. starting new full time job after graduation. So let's say the job starts in June.
3. getting married in Nov

AND if my kid came to me and basically said, "So I know that I'm still on your health insurance but this new job comes with health insurance options and I have no idea how to pick the right now," my advice to my kid (your mileage may vary) would be the following:

• here's a quick overview of how health & dental insurance works...blah blah blah...explain what 'in network vs out of network' means. Explain what a deductible is + how it relates to seeing an in-network vs OON provider. Explain what coinsurance means & when that kicks in. Explain what individual vs family deductible vs OOP (out of pocket) max per year means.
• Explain to kid that most employers give you more than 1 health plan to choose from.
• Explain to kid how to compare the different health plans. This means comparing not only how much $$ per paycheck or per month the premium costs you, but what the indiv/family deductibles, coinsurance amounts, & annual OOP max amounts are for each health plan that the employer offers.
• Explain to kid that sometimes the cheapest plan might require you to see a PCP first for everything and then get a referral/prior auth in order to see a specialist. And I'd explain the pro's and con's of all that. It's not something that most 20-somethings think of since most of them are pretty healthy but you never know when life can throw you a curveball and you'll need to see a specialist for something.
• I'd show the kid what his/her current coverage is under our family's health plan. I'd walk the kid through all of the deductible & other info. AND I'd show the kid how much $$ gets deducted from our paychecks for that.
• Explain to kid what the difference is between a high deductible/HSA plan and a health plan that only has an FSA with it. With the former, any $$ deducted from your paycheck that's in the HSA account at end of the year can be rolled over to next year, but for FSA, it's use it or lose it.
• I'd suggest to kid that he/she review all of this with fiance + offer to explain to his/her fiance if fiance had questions.
• I'd check with my employer's HR department to confirm what the rules are to see if keeping kid on my health plan after he/she is married is even an option at all. If HR says 'No way we're going to allow that,' then that option is not even on the table and, therefore, once kid gets married, he/she will have to enroll in medical insurance through their employer or elsewhere on the open market. Usually employer-based plans are less expensive, but that's not always the case.
• I'd also confirm w/my employer's HR dept to confirm whether or not if kid had a baby/got pregnant, would the maternity care be covered. And I'd validate whether or not once baby is born, can the baby be added to my insurance plan. I'd assume that most insurance policies don't allow you to cover grandchildren.
• Explain to kid that usually once you officially start at a new full time job that includes medical benefits, you (new employee) have 30 days from your 1st day on the job to enroll in benefits. Would recommend to my kid that they ask about this prior to starting the job just so they can confirm that assumption. Trust but verify. ;-)
• Would recommend to my kid that he/she check w/HR dept at their new job to CONFIRM whether or not they can add medical coverage AFTER the 30 day mark post-1st-day-on-the-job if one gets married but you (the employee) do NOT sign up for medical insurance coverage w/in the 1st 30 days of employment. Trust but verify. Don't assume.
• Would recommend to my kid that he/she & future spouse discuss their options together as a couple and make a decision + let them know that I'm here for questions, suggestions, etc.

He's starting the job this month.

 

[Mackenzie Click-Mickelson]

Once HR adds your spouse to your health plan, they electronically notify health plan company, which adds the new member and you get new member cards in the mail. Coverage will be retroactive to whatever the add date is. So even though you won't get the member ID cards until later, spouse will be covered.

Coverage usually (though I'll put not always) is retroactive to the wedding date if the wedding was the life event (following the date deadlines to notify your company).

 

[sam_gordon]

This is an incorrect assumption. The way it works at most places of employment is this:

• Let's say you start day 1 of new job on 6/1.
• By 6/30, you (new employee) have the option to enroll in medical, dental, vision, or any other benefits that the employer offers.
• HR adds you to the employer's health plan. Coverage usually is retroactive to your start date (6/1 in this example).
• Health plan's company mails you a member card. You usually get an email at your work email saying that you're enrolled.
• By 6/30, if you do nothing, no benefits for you. No medical coverage through that employer.
• Let's say then on 11/1, you get married.
• You notify employer that you got married. Call or email HR. Ask them what next steps are. They might ask for electronic copy of marriage certificate along with SSN of your spouse.
• 30 days later - 11/30 - this is your deadline to add spouse to your medical plan, dental plan, etc. at your work. If you do nothing, then only YOU would have medical (or other) coverage through your work (assuming you enrolled in a health plan by day 30 after starting the new job).
• Once HR adds your spouse to your health plan, they electronically notify health plan company, which adds the new member and you get new member cards in the mail. Coverage will be retroactive to whatever the add date is. So even though you won't get the member ID cards until later, spouse will be covered.
• Later on whenever your employer's annual benefits enrollment period occurs for the next calendar year (2027, let's say), you (the employee) have to enroll in coverage all over again just like you did when you first got hired.
• IF the annual benefits enrollment period for all employees is in the fall and that is BEFORE your wedding date, DO NOT WORRY because the wedding will be a triggering event and as long as you add the spouse to your coverage, then it will get added for the next calendar year also. If concerns about this, ask about it directly with employer's HR department.

You don't know if it's an incorrect assumption or not. Maybe I phrased the question wrong... I'm ASSUMING the "yearly term" for the health care plan is January 1. So if he doesn't sign up within 30 days (his HR has told him 90) of his first day, I assume he can't join again until Open Enrollment, which I'm ASSUMING would be around the fall for the plan to take affect Jan 1. If his term is Sept - August like mine is, it's earlier.

I get that marriage allows you to add your spouse to your plan, but, *IF* DS doesn't sign up within x days of his first day, does his getting married allow him to a "new" 30 days to join the plan?

I did find out my company WILL allow married adult children (under age 26) to be on our plan. So that eliminates the "gap" I asked about.

So here are the options...
1) DS joins his new employer's plan now. Once he's married, he can add his wife.
2) DS stays on my plan until some point in the future (no later than him turning 26). Would he be eligible to join his employer's plan if he gets married or just during open enrollment?

 

[VandVsmama]

He's starting the job this month.

That's great!

And...

That doesn't change my answer. So let's say his 1st day on the job is 2/15. He'll probably have until 30 days after 2/15 to enroll in medical, dental, vision & other benefits at the new job.

 

[VandVsmama]

You don't know if it's an incorrect assumption or not. Maybe I phrased the question wrong... I'm ASSUMING the "yearly term" for the health care plan is January 1. So if he doesn't sign up within 30 days (his HR has told him 90) of his first day, I assume he can't join again until Open Enrollment, which I'm ASSUMING would be around the fall for the plan to take affect Jan 1. If his term is Sept - August like mine is, it's earlier.

I get that marriage allows you to add your spouse to your plan, but, *IF* DS doesn't sign up within x days of his first day, does his getting married allow him to a "new" 30 days to join the plan?

I did find out my company WILL allow married adult children (under age 26) to be on our plan. So that eliminates the "gap" I asked about.

So here are the options...
1) DS joins his new employer's plan now. Once he's married, he can add his wife.
2) DS stays on my plan until some point in the future (no later than him turning 26). Would he be eligible to join his employer's plan if he gets married or just during open enrollment?

Re: the red text above - that's something he should ask his new employer.

Re: bolded text above - that's something he should ask his new employer.

 

[barkley]

sam_gordon, I apologize if this is a duplicate of something that's already been suggested but it just occurred to me...

if your employer plan charges nothing to you to keep your son on it then why worry about dropping him at all until he hits 26? it's not like any other plans (short of Medicaid in nature) have any issues with dual coverage (the plans just determine which is primary/which is secondary for payment of service purposes). he could decide to opt into his own employer's at some point/his (then) wife's during a period of open enrollment for their plans or if they meet one of the special enrollment criteria (just b/c they use a criteria to enroll doesn't mean you have to drop him from yours unless your employer has some kind of specific rules that preclude it) but continue with coverage on yours. worst case scenario-he's covered only under yours, best case-he has double coverage under 2 plans (I've been in this situation-it largely cancelled out copays, share of costs for allot of services).