One of my kids wasn't added to our "family" dental plan...not sure what to do??

[ancestry]

I had a an issue where my divorce decree indicated that my ex spouse was to be on my group health benefits for 5 years. During those 5 years i became common law (which is recognized by my insurance) with another woman. When i tried to add her to my insurance, the company dropped my ex.. breaching the court order.

Hell fires rained from the sky for a few weeks while that mess was sorted out..

they ended up making ex wife a child/dependant on my insurance for the last two years..

This is interesting. I noticed you aren't in the states. This wouldn't happen here in most states (although the law does vary by state). Courts can't order a plan to carry someone who is against that plans insurance policy regulations.

The court couldn't force my husband's insurance to carry his ex-wife as it is against the insurance company's policy to carry ex-spouses. She got dropped as soon as the divorce was final. Had he not dropped her he could have been sued by his (then) insurance company for fraud as he was required to report to them under the plan guidelines any changes in marital status.

Same with adult children. My husband has always had to carry his daughter from his first marriage on his insurance. However the insurance drops the children at age 19 unless the child proves that he or she is a full time student. (NOTE this is changing in the new future due to new health care regulations passed by Obama). Prior to the Obama law, the court in New York State couldn't force the insurance carrier in New Jersey to carry an adult child if she wasn't a full time student -- even though New York requires child support until the age of 21. Also his plan will not cover obstetrical care for dependents -- only for the spouse. Meaning if she (the daughter) was to get pregnant the insurance will not cover it.

 

[ancestry]

We get insurance cards for all of us (myself, DW, & all three kids). Did you get a card for your 2yo? Does it indicate Dental?

We NEVER get an insurance card for our dental insurance. Never even got the first one. They only provide a plan number -- no cards.

Even our health care insurance only list DH on it with a note of family coverage. It isn't abnormal for people to not get insurance cards.

 

[bumbershoot]

The person who answered actually giggled when I double checked that he was added to the dental and vision ins. She thought I would not need it, since he does not have teeth. I told her that you never know what could happen, so to please add him...

That's just crazy! My son started getting teeth at 4 months (well, that's when teething started at least)! And in his case, two of his teeth grew in yellow and he was starting at the dentist at right around 1...of course you add the babies...

What a crazy insurance agent.

It isn't abnormal for people to not get insurance cards.

I agree. While we have cards now, the dentists never need them, as they just look up hubby's info. We don't have vision insurance cards, however...



Hopefully they can fix this somehow! We had a WEIRD situation happen several months ago when hubby went in for a dental exam. They called before his visit to ask if perhaps he had died... When we had COBRA for one month, we took him off of the dental insurance (as you can do) since he has a ton of work to be done over time, and we knew it wouldn't be happening during that month or two. When he got a job the next month with his old company, since it had been such a short time, all the benefits went right back to normal (oh thank goodness!!!!!!), and we figured it was all normal. Except that somehow he was still off of the dental, and the way they had it in their system made it appear in the same way that it appears when the insured person has died, and the family members still get insurance.

That took a couple weeks to get cleared up!

Meanwhile, we'd been paying the exact amount for employee, spouse, and children...if we had been paying for just spouse and children it probably would have been harder, but the cost was right...just not in the paperwork!


Hope yours gets resolved.

On the other hand...if it doesn't, it's only $75. Having a family of 3, as we are, means that you don't get a discount on the family rate; you're paying just what it costs. If we have another kidlet or two, THEN we get the discount b/c our costs won't rise. So you could look at this plan year as being not discounted, and you just pay the exact costs for your 2 year old...next year she'll be added to dental and you will start getting the discount b/c you're paying the same amount and getting more value.

 

[CarlisleMom]

I would try to talk to someone else at the agents office. Since they added the baby to medical, they should have added to dental. I press this point to them. You notified them of her birth.


My husband's employer you filled one form out for all coverage. My employer is the same.

 

[seashoreCM]

How much more is the premium with the 2yo compared with without the 2yo?

Why would anybody not add the child to the dental plan when he did add the child to the main medical plan when the premium is the same?

How does anyone go about getting verification in writing that everybody is on the plan?

If one side (the insurance company) invents the system and the rules, then any ambiguity should go in favor of the other side (the insured).

 

[owensamo]

I don't think it's standard practice to automatically add a child to dental insurance at birth. We didn't add our DD to our dental until she was about 3 - when she had her first dentist appt. We kept asking our dentist, who said that as long as there were no issues, she didn't need to see her before then. So we didn't bother putting her on the insurance. She had medical at birth, though.

Our DD didn't get her first teeth until she as 13-14mo old, though, so there wasn't anything for a dentist to do for the first year!

 

[bumbershoot]

But the point of insurance is for the "just in case" moments. I had no idea DS would get teeth so early, and you just don't know when they'll get them. DS smashed out a brand new tooth at 6 months old...now, we did NOT go to the dentist for that (found out a few years later that we should have, they might have been able to do something), we trusted his doc and the ped ER we took him too (triage nurse told us "if he swallowed it and it will pass or dissolve" and told us to go home b/c there were sick people there LOL), but we could have... If we hadn't added him to everything when he arrived, if we'd gone to the ped dentist, we would have had to pay OOP for it.

Now, while I go back and forth on if the total yearly cost of dental insurance is actually WORTH it or not, I flirt with dropping it and just putting that money each month into savings, if you've already decided that dental insurance is a good thing, you want to have it *just in case* you need it.

owensamo, if your kidlet had knocked out a tooth at 18 months, say, just after open enrollment...that wouldn't have been fun to pay for! Teeth are precarious little things, LOL....

 

[vicki_c]

Another point to consider in addition to Molly's points about injuries - what about pre-existing conditions? If you don't add the child until they are a few years old, and if they have an issue - it can get denied as a pre-existing condition since they weren't covered previously. So even though that wasn't the point of the thread - I thought I would just mention it. For the few dollars it would cost to add a child, it would be worth it for that type of reason alone.

I couldn't get a crown replaced when I went from my parents' insurance to my own because the missing tooth was considered a pre-existing condition - it ended up costing $1600 (and this was quite a long time ago!). I got a new crown for Christmas from my parents.

 

[LoveBWVVBR]

This has happened to my family as well. It was with my 16 year old that was just dropped for no reason. My husband has worked for the same large company for the pass 11 years...so she has been covered since she was 5. I believe some INS co's drop as a business decision to save money. I worked as a volunteer that assisted seniors in navigating the ins. paperwork. You can contact your states agency that grants INS co's the right to do business. They have a complaint department. A rep there can help if you must go that route. Good luck.

Wow, what a mess! I hope that they straightened that out for you. In our case, I actually don't think that the ins. company ever added my 2 year-old. I don't think that she was actually dropped. Of course, I have no way to know that for sure since we have never actually tried to use her dental benefits before, though.

I ended up calling The Principal and they gave me a # that DH's boss needed to call. He called it, and they told him that they had to wait another week to talk to him because it would take another week to even get our DD into their system. As of yesterday, the agent STILL hadn't submitted our DD's info to The Principal to even add her on, though I'm thinking that her incompetence can only bolster DH's boss's case when he calls in a week and asks for our DD to be backdated, though.

 

[LoveBWVVBR]

BTW, I think you are at least partially responsible since it's been two years and you haven't noticed the discrepency.

She's 2. She only recently had enough teeth to even warrant a trip to her dentist Our card says "DH's name+family" so I'm not sure how I could have known that the "family" didn't include our 2 year-old She was added to all other coverages through DH's work with no issue. It never even occurred to me that the agent would have failed to add her to the dental ins.

 

[ccgirl]

When my DS2 was first born, my DH called to let his employer know. It's not a huge company, about 200 employees. Anyway, his company added our child to every policy we had, rightfully so. In addition, every time I take my children to the dentist they get an authorization of benefits from the insurance company prior to the visit. I would call the dentist and ask why this wasn't done as well. If your DH employer is so furious, he should be the one paying it. The state of MA is fairly strict with insurance regulations. Every year at open enrollment we get paperwork with the dependents. One year my nephew (my DH and his brother work together) was listed as one of our dependents. So, I scrutinize these documents very carefully. In addition, I am contantly online checking the benefits remaining. Good luck getting this all sorted out.

 

[branv]

Something like this happened to us, but with a twist that shows even evidence doesn't mean you can get restitution.

When DH was hired, his benefits included an automatic life insurance policy for me of half his current salary. We elected to quadruple the coverage. The election form he filled out was one of those triplicate forms, so he received a carbon copy, with the HR persons signature.

So, we considered the matter taken care of. Every year at open enrollment time, we would get a letter and a list of our current benefits, but advised that unless we needed to make changes, everything would remain the same. Since we never needed to make changes, we didn't really pay attention beyond the introductory letter.

Three years later, new health insurance company so we had to re-elect our plan. That was when we noticed that my additional life insurance wasn't on there. I dug back through and found the forms showing he'd chosen it, and that the HR people had signed off on it. But I assume when they actually typed it into the online system, they failed to give me the additional coverage.

Called, spoke to HR and was told that even though it was their fault, there was nothing they could do. We could still try to add the additional coverage, but it would now require approval by the insurance company AFTER I was examined by a physician to prove my physical fitness. Only new hires or "change of status" (i.e. newly married, etc) could get the extra life insurance with no questions asked. Just how their contract was with the insurance provider.

Moral of this story: even with proof of what you've signed up for, be sure to every single year check your elections at open enrollment.

Another point...if DH had been hired just a few years later, all of this would have been handled electronically rather than hand-written forms having to be entered into a system. If you are hired or working for a company that still requires you to elect your benefits using written forms, or even an electronic form that they then re-enter into another system manually, if they don't automatically send it to you, ask for a print-out of your benefits AFTER they have been entered into the benefits system. Don't wait until open enrollment when it may be too late.

 

[WDWorBUST]

I can tell you first-hand that quite often I have employee's not add babies to dental. I do encourage them to if they already have "family" dental because the premium is the same and I have had employees in the past who didn't then use dental services and didn't have coverage because they had never added it. There should always be a form somewhere showing what your husband's intentions were. And even though the insurance company takes care of enrollments, etc the employer should have a copy of that form. If that form can be located the insurance company who should have made sure that it had been carried out needs to try and push it through - ESPECIALLY if the correct premium had been paid for the coverage. With that said, and I'm not saying this is at all the case in this situation, I would have to estimate that 70+% of employees do not pay attention during benefits orientation and/or open enrollment. All they typically hear is the cost. Good luck getting this resolved. I have had similar scenarios when someone was just missed getting added on, and I can't think of a time when we were not able to get it corrected when it was just a data entry mistake.

 

[LoveBWVVBR]

Update in post 1.

 

[sookie]

i had something similar happen to us once before. my enrollment wasn't forwarded at my new job, and of course - my husband came down with pneumonia. I was very upset - and it took some getting things figured out - a few days - but thank god it did. i am glad you got it straightened out because that can be so frusterating.