S.Y. asks from Clearwater, FL on July 08, 2008
Need Insurance Help Please....
Hi moms. So my sister-in-law is about 6 months preggers she has health insurance thru her work and her husband has it thru his work. Word has gotten out at her work they are laying off 30 people, her being one of them, at the end of July. Is there any kind of law against taking insurance away from women who are preggers? Her husband can't get her on his until open enrollment which is in Oct which is when she is due. I thought when you are laid off you get your insurance up till like 3 months, but I could be wrong. Please if anyone has any knowledge in this kind of stuff let me know, she is freaking out.
So What Happened?™
Thank you for all of your help. We found out later that her husband can add her to his insurance if she gets laid off, she will have to switch doctors and hospitals which will suck but at least she will be covered. Thanks again! S.
S.B. answers from Tampa on July 09, 2008
Being 6 mths pregnant myself (I also carry my own insurance through my employer) I can certainly appreciate your concern for your sister-in-law. From what I have understood, there is no law making it illegal in those circumstances since she will be allowed continuation of coverage. She should be eligible by law, for COBRA for 18mths past her date of termination. COBRA is usually costlier though, because the employer paid protion of the coverage must be paid by the insured. Additionally, her husband should not have to wait until there is open enrollment. This would be considered a qualifying event (her loss of job) under which he can pick her up on his health insurance outside of the open enrollment period. Usually the documentation of loss of coverage must be provided to the employer and must be within 30 days of the event (her lay off). Her husband should find out the specifics through his employer. I had been through that several years ago when my husband lost his job and I had to then pick up coverage for the family outside of the open enrollmen period. Hope this info helps and best of luck to your sister-in-law and family.
W.W. answers from Tampa on July 12, 2008
If her Employer has more than 20 employees...which it sounds like it does since they are terminating 30 employees, there is a federal law, COBRA, which requires the employer to notify your sister-in-law of her federal rights to continue her current Health insurance thru COBRA. Her employer is required, by federal law, to notify her of her rights to continue her health coverage within 14 days of the date she is terminated. She would receive this COBRA notification and then have the choice to elect (or sign up)for the COBRA coverage for up to 18 months from the date of her termination. She can elect the same coverage(for example if she has Medical coverage and Dental coverage for herself) or she can elect less coverage (just the Medical coverage for herself) ...the medical coverage would cover all her pre-natal and delivery and post delivery needs and any other medical costs. She can cancel the COBRA coverage in October when her husband can include her on his insurance however, in most cases open enrollment does not go into effect until the following year...he can add her in October but, she will not actually be covered until the future January 1, 2009, for that heath insurance plan year of Jan 1, 2008 - Dec 31, 2009. So, he will need to get a clear understanding of his open enrollment regulations to find out if that is the case. If she would not be covered until January 1, 2009 she can continue with COBRA coverage until January 1, 2009 and then cancel her COBRA coverage effective January 1, 2009 due to her health coverage included under her husband's coverage with his company. Her husband should also check with his company's Human Resources (HR) department... if he has the opportunity to cover her sooner under his insurance due to a "life changing status" ...the change of status of her health insurance because of her employment termination. This may be an alternative but strictly according to her husband's HR Health insurance rules. Meanwhile, the only difficulty with COBRA is the cost; it is not the same monthly cost as your sister-in-law's current monthly health insurance cost. Most of the time, Health insurance is automatically withdrawn from an employee's pay. But, since she will no longer be subsidized with the company's group insurance discount it will be more expensive on a monthly basis for the COBRA premium. So, I can't tell you what the cost will be but, normally it is about 2 to 3 times more expensive per month than what she pays for her current insurance coverage. However, if you price the medical costs of a delivery she may still be "saving" money with COBRA and unfortunately none of us know if there may be complications which would of course increase the out-of-pocket medical cost with no insurance but, would be covered under COBRA. Just let her know that this could be peace of mind to have COBRA coverage (no matter what the cost for this temporary time frame July or August thru January - 7 months) but that is a decision she and her husband should make. At this late stage in her pregnancy she already probably has concerns because of the termination of her job and does not need added stress of health insurance issues. Oh, sometimes a company provides a "severance" package when an employee is terminated which can include continuation of health insurance for a period of 30 or possibly 60 days and salary pay for that time period. Usually that is done to lessen the hardship during the time the employee is trying to locate a new job. However, this severance package is not a guarantee for all employers. But, COBRA, to continue health benefits is a guarantee as a federal law across the United States. If her employer does not offer her the COBRA benefit, the Employer can be fined, not only for not offering it to her, but, fined for each of the other employees which have been terminated and not offered COBRA. So, anyway I hope this gives you some insight to help her and her husband make some choices about what they will do and I wish and pray for a healthy baby and less stress on their family at this time! And you are awesome for reaching out for some answers to help them. Never change from having a kind heart and trying to help others! Good luck to you all!
R.W. answers from Tampa on July 09, 2008
If she happens to be one of the ones getting laid off, she should talk to HR for her insurance company to see if she can get COBRA. It is a system that allows you to coninue paying for your insurance after your employment ends. It will cost her more, but it may be worth it in the long run. She needs to check it out. Good luck. R.
J.B. answers from Tampa on July 09, 2008
ok, if your SIL in laid off from her job, she does have the option of picking up COBRA but that is very expensive. But, if she is laid off, her husband can add her to his insurance immediately, because there is a change in household which change the situation with the insurance. Her husband should immediately contact his HR department and get the paperwork ready just in case this was to happen. They don't have to wait until Ocotber to add her.
There is no law that stop an employer or insurance compay from taking away insurance from a woman that is pregnanat, I know I was 4 months pregnant with my twin boys when i was laid off.
And just to let you know, most insurance coverage ends the night that person is laid off, it doesn't cover for another 30 days. It immediately is stopped.
I would also advise that your SIL contact Medicaid, because she should be immediately approved because she is pregnant and her health insurance coverage will change with the lay off. She should start the process now just to make sure.
I hope this helps!
M.S. answers from Tampa on July 09, 2008
Hi, I used to work somewhere that you were only allowed to add people during open enrollment times to unless there were other circumstances. When my husband was laid off, we were able to add him to my insurance but in the case of my company you had to bring a letter from his HR saying he had been laid off and no longer had insurance and we had to do it within 30 days of him being laid off so if her husband has not already checked to make sure there aren't exceptions to the open policy rule, he may want to do so. Also, with our baby we had to add her within 30 days of her being born.