New job - new health insurance

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I'm not changing jobs or anything.

But this would be good information I guess for anyone.

I cover my spouse on my health insurance.

He has a medical condition, and receives disability.

If I changed jobs, can the new employers insurance carrier say this is a existing condition and refuse to cover him, or coverage for his particular condition?

If I ever accepted other employment, the biggest factor would be making sure he has coverage.

Can I ask the potential employer to find out from their insurance provider what the coverage would consist of prior to accepting employment?

I've interview and hired many people over the years, and I can't remember anyone asking any questions re insurance before hire, excepting very general questions about premiums, etc.

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Medical insurance you receive as a benefit during employement is covered under the Health Insurance Portability and Accountability Act of 1996 (HIPAA)? and under the laws they are pretty much required to accept any new employee (and their family if they opt for family coverage) regardless of pre-existing conditions.

If your current employer includes dental coverage they don't have to pick that up (medical, dental and vision are usually considered 3 seperate programs) but if you have a typical PPO or HMO now and you change jobs and opt for the PPO with your new employer the new PPO would have to accept you (and your family).

You can ask about any benefit when you are interviewing (I wouldn't suggest it on the 1st interview though!). I've hired a few people in the last 3 months and they've all asked. I give them a copy of the PPO plan and a contact person at the provider they can call if they have something very specific they want to know about.

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What fishin' describes is exactly right in your situation, *if* you accept employment with a new job within 18 months and leaving your old job *and* you maintain your old group coverage through COBRA during the interim. Your new plan is now required by law to cover your husband's (or any covered individual) pre-existing conditions as long as it was already covered under a group plan at the time you begin your new job.

If you leave your current job, let your group coverage lapse, and pick up a new group plan, then the new plan is not obligated to cover the pre-existing condition.

You probably wouldn't let your coverage lapse, but I wanted to fill in the blanks for someone else who might be reading.

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What if the new employer does not cover family members?
Not every employer does.

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CalamityJane wrote:

What if the new employer does not cover family members?
Not every employer does.

That is a matter of benefits. The employer may not cover the cost of the spouse's insurance but if you opt to pay for that portion of the premium yourself the insurer is still required to accept any pre-existing condition.

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All I've heard about COBRA is that it's wildly expensive. Don't know if that is true across the board or just for the folks I've known.

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COBRA allows you to pay the full premium to keep your coverage in place for up to 18 months. You don't have to decide right away but if something happens and you need the coverage you'll have to pay all the premiums retroactive to the first month after you left your old job.

For example, assume the total monthly premium is $500 and you were paying $200 of it through payroll deductions and the company was paying the other $300. If you quit your job in June, the first month's insurance not already paid would begin Aug 1st (insurance is usually paid a month in advance). You decide not to take advantage of your COBRA benefits because you're healthy and don't plan on having any unexpected medical bills. If four or five months later (up to 18 months) you all of a sudden need insurance coverage you can retrospectively pay the premiums back to August 1st so that your coverage is current. You'd have to pay the full $500/month for as many months as have passed since July.

Or, if you have on-going medical expenses and want to continue your coverage uninterupted you simply write a check for $500/month to your old place of business and they keep you on their group plan. They are required by law to offer you coverage, but because you are no longer an employee they do not pay the portion of the premium they paid previously.

Osso, that's the long answer to why COBRA is considered expensive. There's no flat rate but it's based on the full premium for whatever coverage the company offers.

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Quote:

Or, if you have on-going medical expenses and want to continue your coverage uninterupted you simply write a check for $500/month to your old place of business and they keep you on their group plan. They are required by law to offer you coverage, but because you are no longer an employee they do not pay the portion of the premium they paid previously.

Not quite J_B. If one's employment is terminated,
the previous employer is not allowed to continue coverage
for the employee, except for an additional 30 days, following the termination. They are not required by law to offer
coverage to terminated employees.

Plus, $ 500 for healthcare coverage is very high if you're
not employed. So yes, COBRA is expensive.

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CalamityJane wrote:

Not quite J_B. If one's employment is terminated,
the previous employer is not allowed to continue coverage
for the employee, except for an additional 30 days, following the termination. They are not required by law to offer
coverage to terminated employees.

Unless the employee is terminted for gross misconduct the employer is required under COBRA to allow the former employee to participate (at their own expense) in the existing plan that they had been enrolled in while they were an employee.

http://www.dol.gov/ebsa/faqs/faq_consumer_cobra.html

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Yes fishin, having a COBRA insurance at his/her own expense,
however, I was referring to J_B's last paragraph (I quoted on)
where she wrote that the employer can keep the employee
on the corporate insurance plan.

A former employee can have with COBRA the same group plan coverage as the former employer offered, yes, but not remain
on the business plan.

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If you are trying to say that the former employer isn't allowed to pay for the ex-employees COBRA coverage I'd agree with you.

The use of the word "plan" twice in that last sentence of your previous post is extremely confusing. Razz

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Oh! Sorry, I didn't mean to be extremely confusing, but, yes, that's what I meant fishin', the COBRA coverage is to be
paid by the ex-employee.

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Information I was given has it that a terminated employee can elect coverage within that 18 month (36 for retirement) if, and only if, they were not notified of their right to continue coverage within either 30 or 60 (not sure which) days of the end of the coverage under the group. I use certified mail for this purpose, and well under 30 days.

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C_Jane,

Are you saying the COBRA coverage is under a different plan than the employee plan? I don't think that was the case for Mr B. We had to notify his plan administrator in the benefits dept that he was electing COBRA coverage. As far as I know our coverage, group id, plan carrier, etc. all stayed the same. The premium checks were made out to the employer and our coverage continued under the old plan.

Quote:

Changing Jobs

Changing jobs can affect the health benefits of you and your family, as you are usually no longer eligible to participate in your former employer's group health plan. However, you may become eligible to participate in your new employer's group health plan. Knowing your options and understanding your rights can assist you in maintaining the best health coverage for you and your family.

Depending on your circumstances, you and your family members may have the opportunity to enroll in your new employer's plan or purchase COBRA continuation coverage at group rates under your former employer's health plan. You and your family members may also have the right to enroll in a group health plan sponsored by your spouse's employer. There may also be opportunities available to you outside the group health plan context.

Before making any decisions, you should carefully consider the information on the coverages for which you and your family members may be eligible to determine which one best meets your needs.
http://www.dol.gov/elaws/ebsa/health/54.asp

$500/month for someone who is unemployed is expensive but the premium doesn't change from what it was before. It's covered entirely by the policy holder so it seems more expensive but the base cost of the coverage is the same.

Here's another use of COBRA: My sister is approaching retirement age. She plans to retire at age 63.5 and pay the 18 months insurance premiums under COBRA until she quallifies for Medicare. She's no longer working for the income, but because of her husband's medical needs she isn't able to go without insurance coverage.

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Wow, great information all!

Thanks!

I hope this helps others as well.

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I mentioned this topic to my sister, the benefits guru, and I need to correct part of my COBRA statement. I said you could decide at any point to elect COBRA benefits and retrospectively pay all the back premiums to the date the coverage lapsed. Not true. You must elect to continue your coverage within 60 days and the payment is due within 45 days after that. She counsels her staff to sign and submit their election forms by day 59 without payment even if they are not planning on carrrying the coverage. Then if they get other coverage within the next 45 days they simply don't pay the premiums and all if forgotten. If they haven't found other insurance and want to continue their coverage under their old plan they need to make the retrospective payment before day 105.

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Oh, COBRA vs employer plan. When the group - the entire group, not just those electing coverage - reaches 20 employees, the employer's plan becomes subject to COBRA rules. I may not be current on the size of the group, but it is the group size which determines when the employer plan becomes a COBRA plan.

On the retroactive payment at some future date, it can happen if the employer fails to document the employee's notification. This can subject the employer to catastrophic medical expenses incurred by the former employee.

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New job - new health insurance

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