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How can I get on my wifes health ins? Wisconsin

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  • How can I get on my wifes health ins? Wisconsin

    Years ago when my wife went back to work my insurance paid for everything so I opted to not recieve medical ins. from her employer. She is on mine and hers. As the years have gone by my employers insurance has gotten worse and worse to the point that it is costing my a bundle. We have repeatedly asked her employer to add me to her coverage but they keep saying "No, there is no open enrollment". I don't think this is fair seeing as how other employees have thier spouses covered? Any help would be appreciated.

    Thanks

  • #2
    How is there no open enrollment? Is this plan fully funded by the employer or using post-tax dollars?
    I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

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    • #3
      There should be an open enrolment, at least once a year when the policy is renewed. Also, if you have a life changing event they must allow you to enroll at that time.

      I doubt that your insurance going up would qualify, but call the insurance carrier (number on the back of the card) directly and ask them.

      If the insurance provided by your job cancelled you, your wife's company would allow you to sign up. Unless your wife’s company only offers coverage to the employee, but that rule would have to apply to everybody classified the in the same way as your wife.

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      • #4
        Is an annual "Open Enrollment" the law? They don't do any kind of open enrollment? It's not a small company. 300-400 employees.

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        • #5
          We only have 30 employees and offer open enrolment once a year. It may be the employer’s choice, but they have never told me about that option. But, I have never asked to exclude that option so it may be possible.

          I have been given the choice of adding, or not adding, people who have not reached the 90 day waiting period during open enrollment. The waiting period is up to the employer

          I will speak to my agent tomorrow and ask him about the laws.
          Last edited by TM1; 01-16-2008, 04:35 PM.

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          • #6
            Also, if the premiums are deducted on a pre-tax basis, the law requires an open enrollment.
            I don't respond to Private Messages unless the moderator specifically refers you to me for that purpose. Thank you.

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            • #7
              Originally posted by drewkazoo View Post
              Is an annual "Open Enrollment" the law? They don't do any kind of open enrollment? It's not a small company. 300-400 employees.
              When it is a plan that is paid for via pre-tax dollars, then there are rules and regulations that govern when someone may join or leave a plan. If this plan is fully funded by the employer or is not a pre-tax plan, those issues are governed by the plan documents. I was the administrator for such a plan for 5 years and we did have an open enrollment, as do most others. I've never heard of a plan not having one, though it isn't required.

              Have you asked if there are any circumstances under which you would be able to join the plan?
              I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

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              • #8
                My insurance agent agreed that not having an open enrollment was odd.
                He wanted to know who the carrier / insurance company is. He also asked for her renewal date.

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                • #9
                  Money comes out of her check weekly towards the premium. I'll ask about the other things that have been postulated here and reply. I just don't think it's fair that other employees spouses are covered and I can't get coverage?

                  This situation has been going on for years.........

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                  • #10
                    The question is not, does money come out of her check towards the premium. The question is, does that money come out of her check pre-tax or post-tax?

                    It makes a difference to the answer.
                    The above answer, whatever it is, assumes that no legally binding and enforceable contract or CBA says otherwise. If it does, then the terms of the contract or CBA apply.

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                    • #11
                      The name of the insurance carrier is "HealthEOS by Multiplan". Her "Effective date is 4-1-98".

                      Her premium is being paid Post tax.

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                      • #12
                        If it is post-tax, then an open enrollment period is not required, though I've never heard of a plan not having one anyway. I'd ask specifically what needs to happen in order for you to join the plan. This should be detailed in the plan documents.
                        I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

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                        • #13
                          Assuming that there are plan documents. Absent the Section 125 plan being implemented, all we have are the older IRC 104-106 rules. The following quote is from IRS publication 15B (Fringe Benefits):

                          Accident or health plan. This is an arrangement that provides benefits for your employees, their spouses, and their dependents in the event of personal injury or sickness. The plan may be insured or noninsured and does not need to be in writing.
                          "Reality is that which, when you stop believing in it, doesn't go away".
                          Philip K. **** (1928-1982)

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