I just don't know what to do - long post

[doxdogy]

Anyone that has any suggestions on how to help, I would be grateful. A new company is slated to take over our contract at the beginning of the year. It is what is called an SCA contract. Which is good because salaries will go up. Now for the bad, they have to include a 3.01 health and welfare benefit. They can either give it to us or give us benefits. They chose to give us benefits with no option to decline. The problem is the medical benefits are a limited flat rate indemnity plan. It is not considered major medical insurance. Hospitalization is paid at $1200 per day. That only covers room and board, nothing else. We pay for all other services received while in the hospital. For medical tests they only pay $90 anything above that comes out of pocket. One employee will have to quit because her good benefits through her spouse become secondary and this insurance becomes primary. The new company is aware of what kind of insurance they are giving us, they know employees will have to quit. Their answer you can not opt out. The price will go up if you opt out. Translation it will cost them money. We have contacted the dept of labor they can't help. The person in charge of the contract award knows, yet won't comment. The only bright spot on the horizon is that the award is under protest. Any ideas on what we can do?

 

[lil mermaid]

If this is a government contract under the Service Contract Act (which it sounds like it is) there really isn't anything that you can do. The SCA only requires the contractor to pay Health & Welfare benefits in the amount of $3.01 per hour, and they don't have to do more than that. As long as the successor contractor is paying that minimum amount, they don't have to do anything more.

 

[DMickey28]

This sounds interesting. I am not clear how health insurance really works but I had a question.

If this insurance become's primary for your co-worker and her husband's becomes secondary, wouldn't she still recieve full coverage just from two different companies? I always assumed that what ever the primary company didn't pick up the secondary one would... maybe I have been wrong the whole time...

 

[LuvN~Travel]

The secondary company may not pick the rest up, though.
We had that happen with our insurance back in '94. Mine had been primary, my DH's secondary. The earliest birthday came into being, and mine switched to secondary. When mine was first, it paid some, then his paid the rest.
However, when mine was secondary. if his paid $75.00 toward a $100.00 bill, mine would say 'well here is $5.00 more towards the $80.00 we would have paid anyway. They didn't just 'cover' what was left! What a pain! It didn't take us long to drop his insurance for family, since overall mine paid better.
Good luck!
Kim