Question
What is the name of your state?Ohio, husband in North Carolina
I am leaving my job due to the termination of health coverage due to non-payment by the employer and because of non-payment of wages. I found out today that because of non-payment, the health insurance was cancelled as of 10/1/2005. I will be going to North Carolina to get on my husband's insurance (he works at a hospital). Because I didn't find out about the cancellation for over 30 days from the date of cancellation, will this impact my move to Nick's health insurance? I am worried about not having continuing coverage. I have not given my notice yet, but will be doing so shortly. Is there any possibility that my pregancy will be considered a pre-existing condition?
Answer
I'll answer the last part of your question first. No, there is no possibility of your pregnancy being considered a pre-existing condition if you move to your husband's plan. Under the law, an employer sponsored group health plan CANNOT consider pregnancy to be pre-ex, regardless.
The answer to your other question is harder. If your husband's plan is under a Section 125 plan, and the odds are better than even that it is, then technically under the law they are not allowed to add you to the plan more than 30 days after the cancellation of your coverage. To do so would be a violation of the law, not just the plan document.
However, since the policy was cancelled retroactively, you could easily make the case that you ARE within the 30 days, since it is within the last 30 days that your insurance carrier took steps to cancel the plan. I can't offer any guarantees but I think most employers will be reasonable about this situation.
I have to warn you, though. It is VERY likely (not a guarantee, but very close to one) that your husband's employer and/or their carrier, will want written verification of the date of coverage, and in your case that's going to mean verification that it was a retroactive cancellation. Chances are VERY good that you will have to ask either your employer, or your insurance carrier, or both, for such verification. While the law requires one or the other of them, or both, to provide you with what's known as a HIPAA certificate which will provide that information, under the law they have longer to provide you with the certificate, than you have to get your coverage in order. (I have no clue why that is; just another example of government bureaucracy, but a well known problem in HR/benefits and insurance circles.) You will probably have to ask one or the other of them to write you a letter unless the HIPAA certificate arrives much faster than they are required to provide it. Which is possible; not everyone waits until the very last minute to send things out! But the possibility very definitely exists, and they are not required by law to provide anything but the HIPAA certificate.
Just to give you more to worry about, huh!
Answer
Thanks!
Well, for clarification, Nick and I aren't married yet, we are engaged and we are getting married in two weeks. This would qualify as a change in status, correct? Would the more than 30 days count then? I actually overheard the boss say to the controller to let the health insurance check bounce. Nice.
I will have a copy of the letter of retroactive cancellation, because those things come to me in the company mail. Am I allowed to take a copy with me, or do I have to ask?
Answer
we are engaged and we are getting married in two weeks. This would qualify as a change in status, correct? Correct.
Would the more than 30 days count then? Once you're married, a different 30-day period applies. Your husband will have 30 days to inform his employer he has acquired a legal dependent and add you to his insurance plan.
I just skimmed the above but I think what cbg is referring to is the "certificate of credible coverage" your employer is obligated to provide upon termination of your health insurance. If you obtain new health insurance coverage within 63 days (don't quote me on that exact number but I think it's correct), then the new insurance carrier cannot enforce any pre-existing clause condition. I'm not as close to this kind of thing as I once was but I think pregnancy is excluded from any pre-x condition entirely.