Private medical insurance

[acalliste]

This is starting to become an issue for me.

The company I work for goes through this dependent verification process in August (this will be the 2nd or 3rd year they've done it) to make sure the dependents you are paying for on your plan really qualify as dependents. If not, there is some sort of bad voodoo that will come back on you, can't remember exactly what but could involve paying back claims paid out by the insurance or possibly even getting fired, I can't recall now.

So they want copies of tax returns, birth certificates, whatever. If the dependent is 19 or older, they have to be enrolled in school. This year they have sent out notices early saying this is your chance to drop any kids that don't qualify from your plan before they actually verify. And it says 19 and older have to be enrolled in school full time.

My son is considered part time at Valencia. I think he was part time at this time last year too, but can't remember for sure. But no one came back and said anything to me about it. Therefore I think perhaps the requirements have change for my company from part to full time enrollment.

So... he can add a class for the next semester and become full time, but the next semester doesn't start until 8/30, so if the company does their verification before he is reflected as full time at the school, I could be in trouble.

I am going to call HR on Monday and try to find out if him adding a class will be enough to keep me out of trouble or if I need to just go ahead and drop him.

And if that happens, I am probably just going to drop my company health insurance all together and see if I can find private insurance that won't penalize him for being part time.


Anyone have private health insurance? Know of a good place to start looking? I'm paying about $1600 a year now with a sizable deductible. And that's with having to reduce my plan quality for this year because the prices went up a lot.

[acalliste]

This is interesting. I posted this thread on FSB and Demented replied with the following link:

Statutes & Constitution :View Statutes : Online Sunshine

Specifically:
627.6562 Dependent coverage.--

(1) If an insurer offers coverage under a group, blanket, or franchise health insurance policy that insures dependent children of the policyholder or certificateholder, the policy must insure a dependent child of the policyholder or certificateholder at least until the end of the calendar year in which the child reaches the age of 25, if the child meets all of the following:

(a) The child is dependent upon the policyholder or certificateholder for support.

(b) The child is living in the household of the policyholder or certificateholder, or the child is a full-time or part-time student.



However there is also a part that says:

(4) This section does not:

(c) Require an employer to pay all or part of the cost of coverage provided for a dependent under this section; or


So.. does that mean they can't make me drop him, but they don't have to pay for any of his premium? In which case it's probably not worth making waves about, if the end result is I will pay as much as I would if I got private insurance, and piss off my employer in the process.

[NeedinJustice]

If their requirement is for him to be full time, I'd just register him for an additional class. You can print his new class schedule for the proof that he's full time. Private insurance will be WAY more than $1600/year. I have friends that are a bit older who are paying like $700/ month and they still have large deductibles. You may also have to contend with them not wanting to cover his pre-existing medical stuff.

[NeedinJustice]

Originally Posted by acalliste

This is interesting. I posted this thread on FSB and Demented replied with the following link:

Statutes & Constitution :View Statutes : Online Sunshine

Specifically:
627.6562 Dependent coverage.--

(1) If an insurer offers coverage under a group, blanket, or franchise health insurance policy that insures dependent children of the policyholder or certificateholder, the policy must insure a dependent child of the policyholder or certificateholder at least until the end of the calendar year in which the child reaches the age of 25, if the child meets all of the following:

(a) The child is dependent upon the policyholder or certificateholder for support.

(b) The child is living in the household of the policyholder or certificateholder, or the child is a full-time or part-time student.



However there is also a part that says:

(4) This section does not:

(c) Require an employer to pay all or part of the cost of coverage provided for a dependent under this section; or


So.. does that mean they can't make me drop him, but they don't have to pay for any of his premium? In which case it's probably not worth making waves about, if the end result is I will pay as much as I would if I got private insurance, and piss off my employer in the process.

That last part translates into you being responsible for the entire portion of him being covered...the company CAN pay part, but don't have to.

[acalliste]

Well, except they are going to verify it themselves, so if the school doesn't show him as full time until the class actually starts, that won't help me.

[acalliste]

I might just drop the whole fucking thing all together. I can think of better things to do with $1600.

[acalliste]

I spend so much money on insurance, it's totally ridiculous. I could pay off all my credit card debt with what I pay out in insurance.

[NeedinJustice]

Just don't shoot yourself in the foot. You should start getting quotes from different places to see what it would cost you to drop it. Nothing wrong with getting estimates.

I don't know that the school is legally allowed to verify anything unless you/your son signs a waiver. Heck, my son had to sign a release with the college for me to be able to find out any information about how his schooling is going there or anything at all with them and he's a minor, so I'm pretty sure your son would have to sign one too.

[acalliste]

I don't know if they have access to the college clearing house or not. Whenever I have to deal with SallieMae, they run a report from the clearing house and look for his name it make sure he's enrolled. No one has ever challenged me about whether I should know anything or not.

[NeedinJustice]

He may have already signed something then with Sallie Mae, but they told us flat out that unless our kid signed the waiver, they wouldn't be able to tell us anything, even with our kids being minors...kinda crazy.

I'm just afraid that what it would cost for private insurance would be many thousands of dollars. Do they pay for your part or for half for your part of the policy?