New insurance fee... am I missing something?

[kamik86]

So in our new health insurance information last year my company introduced a fee (over 900 a year) if you have your spouse on our insurance even though they have coverage through work (that is in addition to the increase in premiums to go from employee coverage to employee + spouse so I have to pay 900 more for the same coverage then a coworker whose spouse doesn't work)

I got stuck paying it all this year and now they are making the fee even larger.

Here is my problem on why I can't come up with any way to avoid it.

The solution would be have my husband have insurance through his job right? Except his open enrollment is in March. Mine is in November.

It is my understanding that he can't get insurance through work outside his annual enrollment just because we are no longer covering him on mine (if my work decided to just drop spouses he could as he wouldn't be eligible here but he still is, Just with insane fees)

If I cover him now he can't get his insurance in March and drop from mine either. As he still wouldn't' be starting a new job to have a qualifying event under my plan to drop him.

If the fee had been in place all along it would have been fine as we would have set it up separately when we started working but now it seems there is no way to split it.

We can't drop him from having insurance at all because then we get all the tax penalties and a huge risk of having no insurance until his kicks in.

And keeping him on mine and then picking up his would mean not only paying this insane fee for another year but adding on TOP of that his preimiums for redundant coverage.

Am I missing something? Is there some other option here?

 

[lovemygoofy]

In my insurance handbook, it says dropping a spouse from an insurance plan is a change of life qualifier for special enrollment.

Tell your husband to ask his HR person or look in his benefits book for change of life qualifiers.

 

[flexsmom]

I'd have your husband check with his HR about being able to enroll outside of his open enrollment due to a change in life circumstance. Usually people can make changes or enroll if something significant happens (marriage, death, birth, and I believe loss of insurance through another source). I say this because we had a similar situation where DH was facing a layoff and he carried out family insurance. My HR told me that should that occur, I'd be allowed to enroll at any time even outside of our open enrollment.

As an aside, the fee you are facing is going to become more common. I just finished a training course on the economic decisions facing companies as a result of ACA implementation should the company be covered by the law. It is believed that spousal coverage will be dropped by many companies, and where it is kept, it will be more expensive because it is not part of the "affordability" determination a company has to meet. Employee coverage can be no more than 9.5% of the employee's household annual income (don't ask how a company is supposed to know what that figure is without being intrusive!), but the fee for spousal insurance isn't capped by that "affordability" determination. Under the law, "dependent" is now defined as children or elderly people you claim - not spouses. So we will start to see more situations where husband and wife carry different insurance - possibly though different insurers, and then one of them carries the kids.

I shudder for the day that happens in our family as it's enough of a pain to deal with one insurer much less two!

Good luck!

 

[TheIncredibles!]

So in our new health insurance information last year my company introduced a fee (over 900 a year) if you have your spouse on our insurance even though they have coverage through work (that is in addition to the increase in premiums to go from employee coverage to employee + spouse so I have to pay 900 more for the same coverage then a coworker whose spouse doesn't work)

I got stuck paying it all this year and now they are making the fee even larger.

Here is my problem on why I can't come up with any way to avoid it.

The solution would be have my husband have insurance through his job right? Except his open enrollment is in March. Mine is in November.

It is my understanding that he can't get insurance through work outside his annual enrollment just because we are no longer covering him on mine (if my work decided to just drop spouses he could as he wouldn't be eligible here but he still is, Just with insane fees)

If I cover him now he can't get his insurance in March and drop from mine either. As he still wouldn't' be starting a new job to have a qualifying event under my plan to drop him.

If the fee had been in place all along it would have been fine as we would have set it up separately when we started working but now it seems there is no way to split it.

We can't drop him from having insurance at all because then we get all the tax penalties and a huge risk of having no insurance until his kicks in.

And keeping him on mine and then picking up his would mean not only paying this insane fee for another year but adding on TOP of that his preimiums for redundant coverage.

Am I missing something? Is there some other option here?

$900 per year = about $17.00 per paycheck. If he picked up insurance through his company what would his weekly employee contribution be towards healthcare coverage?

Speak with your HR representatives at both companies and ask what they recommend you do. They are the ones that know both plans the best.

 

[kamik86]

I'd have your husband check with his HR about being able to enroll outside of his open enrollment due to a change in life circumstance. Usually people can make changes or enroll if something significant happens (marriage, death, birth, and I believe loss of insurance through another source). I say this because we had a similar situation where DH was facing a layoff and he carried out family insurance. My HR told me that should that occur, I'd be allowed to enroll at any time even outside of our open enrollment.

As an aside, the fee you are facing is going to become more common. I just finished a training course on the economic decisions facing companies as a result of ACA implementation should the company be covered by the law. It is believed that spousal coverage will be dropped by many companies, and where it is kept, it will be more expensive because it is not part of the "affordability" determination a company has to meet. Employee coverage can be no more than 9.5% of the employee's household annual income (don't ask how a company is supposed to know what that figure is without being intrusive!), but the fee for spousal insurance isn't capped by that "affordability" determination. Under the law, "dependent" is now defined as children or elderly people you claim - not spouses. So we will start to see more situations where husband and wife carry different insurance - possibly though different insurers, and then one of them carries the kids.

I shudder for the day that happens in our family as it's enough of a pain to deal with one insurer much less two!

Good luck!

I know if I lost my job or even if my job stopped allowing my husband to be covered that it would count as a change of life and he could get his insurance. I didn't think it would work that way if we choose not to enroll him again this year though. If it does that would solve the problem. I just asked him to check...

 

[MSLRAC]

$900 per year = about $17.00 per paycheck. If he picked up insurance through his company what would his weekly employee contribution be towards healthcare coverage? Speak with your HR representatives at both companies and ask what they recommend you do. They are the ones that know both plans the best.

I was wondering about the $900 a year as well. That seems really cheap.

Anyway, I'd check with both HR depts. I know that we could drop our coverage at DH's work right now (for any reason) and that would be a qualifying event to sign up at my work and our open enrollment isn't until December.

 

[poohfriend77]

I was wondering about the $900 a year as well. That seems really cheap.

Anyway, I'd check with both HR depts. I know that we could drop our coverage at DH's work right now (for any reason) and that would be a qualifying event to sign up at my work and our open enrollment isn't until December.

It sounds to me like she does pay premiums for DH (she stated employee + spouse was more than just employee). I think the $900 is just a fee on top of premiums, just for the privilege of paying spouse's premiums. Is that right, OP?

I would assume her premiums were cheaper or coverage was better than DH's plan in the first place, which is why he is covered under her plan. But the extra $75/mo make his plan a better deal now. Hope you can get it all sorted out, OP!

 

[Hoodie]

My husband's company does the same thing, but the extra fee is $50/paycheck or about $1,300 a year. And yes, that's in addition to the higher premium to have me covered in the first place.

Like others have said, have him check with his HR department about being added off season. Then crunch the numbers. The higher premium you pay plus the additional fee may still be cheaper than getting his own policy.

 

[kamik86]

It sounds to me like she does pay premiums for DH (she stated employee + spouse was more than just employee). I think the $900 is just a fee on top of premiums, just for the privilege of paying spouse's premiums. Is that right, OP?

I would assume her premiums were cheaper or coverage was better than DH's plan in the first place, which is why he is covered under her plan. But the extra $75/mo make his plan a better deal now. Hope you can get it all sorted out, OP!

Yes it is in addition to the spousal premium. You actually got the situation exactly. My coverage was a bit better originally then his but between the additional fee, the changes to our plan, and the fact that getting my husband to go to the doctors is like I was asking to pull all his teeth out make it not worth the hassle.

Update:
I did just hear from my benefits coordinator and she said that it will be a qualifying event at my company if he got insurance in March so I could take him off mine then. So I at least have that option even if his work won't allow him to add his coverage now.

 

[MSLRAC]

It sounds to me like she does pay premiums for DH (she stated employee + spouse was more than just employee). I think the $900 is just a fee on top of premiums, just for the privilege of paying spouse's premiums. Is that right, OP? I would assume her premiums were cheaper or coverage was better than DH's plan in the first place, which is why he is covered under her plan. But the extra $75/mo make his plan a better deal now. Hope you can get it all sorted out, OP!

Oh wow, that fee seriously stinks if that is the case! I hate insurance! Ours was ridiculously overpriced and crappy before ACA and now it's even worse. I seriously don't know how some people do it.

 

[Allison]

Oh wow, that fee seriously stinks if that is the case! I hate insurance! Ours was ridiculously overpriced and crappy before ACA and now it's even worse. I seriously don't know how some people do it.

This is about companies facing big costs of medical premiums for people who have the ability to get insurance coverage from their own employer and not the spouse's employer. They want to encourage people to take coverage where they work, not where the spouse works.

Companies around here have put requirements in place that if your spouse can get coverage at their place of employment, the spouse cannot be on your plan.

 

[kamik86]

This is about companies facing big costs of medical premiums for people who have the ability to get insurance coverage from their own employer and not the spouse's employer. They want to encourage people to take coverage where they work, not where the spouse works.

Companies around here have put requirements in place that if your spouse can get coverage at their place of employment, the spouse cannot be on your plan.

The other reason those at my office hate this fee so much is that they said the reason for the fee is that they feel with ACA that they will have additional costs in covering spouses that weren't covered before and could be covered elsewhere.

However that assumes that:
1) There were people at the company whose spouses were eligible for coverage at our company AND the spouses employer yet chose not to get coverage. In some income brackets maybe but the lowest full time pay here is still high enough that I doubt there were many of those at all.

2) That more would get coverage now if they fell in category 1. But that was completely false for our office. We are in MA, we had tax penalties for not being covered by insurance since at LEAST 2009. So the part of the ACA that they are claiming changed and made this happen didn't actually change anything here.

 

[aprilchem]

We were in the same situation, and a spouse with a different enrollment date is a qualifying life change. Just enroll him in his plan and drop him from yours when his open enrollment period starts.

 

[Patch'sD]

At least your saving $2,500 per year and if you like your Dr, you can keep your Doctor, Not

 

[MSLRAC]

This is about companies facing big costs of medical premiums for people who have the ability to get insurance coverage from their own employer and not the spouse's employer. They want to encourage people to take coverage where they work, not where the spouse works. Companies around here have put requirements in place that if your spouse can get coverage at their place of employment, the spouse cannot be on your plan.

I guess that's why we haven't dealt with such a fee. Both DH and my employers only pay half of the employee coverage. Adding a spouse or kids is at the expense of the employee.

 

[havaneselover]

I guess that's why we haven't dealt with such a fee. Both DH and my employers only pay half of the employee coverage. Adding a spouse or kids is at the expense of the employee.

This is how mine works too. I think a lot of people don't realize how lucky they are and how much insurance really costs.

 

[ICF]

We've had an additional $1500 surcharge for a spouse for a number of years that is over and above the actual cost of the insurance.

 

[mousefanmichelle]

For us if there is a gap in coverage like your's our benefit period is Jan - Dec and your spouses if Mar - Feb we can pay the monthly fee until they can then pick up their insurance in Mar and then we can drop them on our policy thus discontinueing the monthly fee. Our HR dept recognizes this and allows us to. You should check again with your HR dept.

 

[DaretoDis]

It will all get better when the employer mandate takes effect next year.

 

[Happy Snowman]

Yes it is in addition to the spousal premium. You actually got the situation exactly. My coverage was a bit better originally then his but between the additional fee, the changes to our plan, and the fact that getting my husband to go to the doctors is like I was asking to pull all his teeth out make it not worth the hassle.

Update:
I did just hear from my benefits coordinator and she said that it will be a qualifying event at my company if he got insurance in March so I could take him off mine then. So I at least have that option even if his work won't allow him to add his coverage now.

It is a life event at both companies. He should go talk to HR now, tell them he is losing your coverage because of a surcharge and get the paperwork in motion to start his company plan in January when your surcharge starts. There is no reason to wait until March.