Open enrollment- health insurance question.

6fsn · December 2018

At open enrollment for my husbands company I was a contract employee with no access to my company health care. My husbands insurance has a penalty if you have access to healthcare but opt out.

My my company wants to bring me on as a part time employee. I need to verify if I have access to the insurance, but if I do I need to go back to my husbands company and tell them? Open enrollment is closed. I’d be an employee as of Jan 1

If I have to go back and either buy my company’s insurance or take the penalty for dhs I’ll need to do some negotiating.

MNNEBride · December 2018

If, as a part time employee, you'll have access to health insurance, you will need to contact HR/Benefits at your DH's company. And you'll take the penalty for declining your company's insurance.

My company also has the penalty for a spouse opting out of their employer's insurance. My DH was eligible for his insurance but it was outrageously expensive so the penalty was definitely much cheaper for us. Last year, he dropped to less than 30 hours and was no longer eligible for insurance at his work so I made the change with my employer and no more penalty.

If you have access to insurance as a part time employee, I would definitely negotiate a wage high enough to cover the penalty you'll pay for declining the insurance. Actually, it might be well worth your employer paying you the difference because then they don't have to pay the employer portion of your premium.

Just my .02. I know there are other ladies on here who are on the insurance side of things.

short+sassy · December 2018

Having access to health insurance through your employer on Jan. 1st would be a qualifying event that would allow you to drop off your H's policy, even though it is no longer open enrollment.

If you haven't already, double check that you would be eligible for healthcare on your first day of employment. Some companies will make new employees wait 30, 60, or 90 days before benefits kick in.

A question for H's HR would be if they base the penalty on a spouse's status during open enrollment. Or at any time throughout the year, if that situation changes.
Questions for your HR are if you are even eligible for medical benefits. And, if so, how much will they be.

Then, "compare and contrast" the penalty (if applicable) vs. opting for your company's healthcare (if applicable). Or, if you're better off just staying totally contract not taking the p/t job.

I know you know all or most of that, lol. I am just trying to help boil it down to the nitty-gritty questions you need the answers to.

banana468 · December 2018

I think because your situation would be changing your H can make changes to plans because it's a qualifying event. That's similar to adding a baby or getting married.

Tangent: I FUCKING HATE the penalty clause and think that they're bullshit. It now costs DH and me more money for health insurance because DH and I have full time jobs and we'd pay $1300 to be on his insurance PLUS the additional cost of me on it or I can go through my company's insurance for a slightly different level of care.

Let's not talk about the fact that this is supposed to be offered to all employees and spouses as an equal benefit and now he's essentially not getting something that his coworkers get. Let's not talk about how he works with guys who have wives who CHOOSE to stay at home. And theoretically they have "access to" healthcare if they wanted to buy it on an exchange. And he also works with other people who are married to small business owners or work by contract so they technically don't have "the same access to insurance" but they bring in more money per year. Nope. Let's screw over employees in the name of saving money on an unequal basis. Make it the same or nothing. Don't penalize just the employees with spouses who have jobs.

kvruns · December 2018

Check to see if the offer of insurance at a part-timer is subsidized by the company or not. Some employers will offer insurance to part-time employees but you are going to have to pay a higher premium than a full-time employee.

I'd also check with DH's HR department to better understand their policy, meaning is it access to any insurance through the spouse's work or access for a FT employee since those can be drastically different costs.

If you do end up taking your own insurance you would let DH's company know the effective date. If the effective date is January 1 they probably would just cancel you from the enrollment as an "administrative error" or similar. Technically it is also a qualifying life event to drop his coverage since you gained new eligibility to coverage.

cupcait927 · December 2018

@short+sassy has it covered and said it better than I could! I work in employer benefits and she's spot on with her advice.

ShesSoCold · December 2018

cupcait927 said:

@short+sassy has it covered and said it better than I could! I work in employer benefits and she's spot on with her advice.

Exactly what I was going to say!

6fsn · December 2018

Thanks all! It ends up I don’t have access until I consistently work 30+ hrs anyway. I’m pretty close but not quite there. Is I have the info for nextvyear

sparklepants41 · December 2018

banana468 said:

I think because your situation would be changing your H can make changes to plans because it's a qualifying event. That's similar to adding a baby or getting married.

Tangent: I FUCKING HATE the penalty clause and think that they're bullshit. It now costs DH and me more money for health insurance because DH and I have full time jobs and we'd pay $1300 to be on his insurance PLUS the additional cost of me on it or I can go through my company's insurance for a slightly different level of care.

Let's not talk about the fact that this is supposed to be offered to all employees and spouses as an equal benefit and now he's essentially not getting something that his coworkers get. Let's not talk about how he works with guys who have wives who CHOOSE to stay at home. And theoretically they have "access to" healthcare if they wanted to buy it on an exchange. And he also works with other people who are married to small business owners or work by contract so they technically don't have "the same access to insurance" but they bring in more money per year. Nope. Let's screw over employees in the name of saving money on an unequal basis. Make it the same or nothing. Don't penalize just the employees with spouses who have jobs.

AMEN. This is H's company as well and we had to take the penalty a couple of years ago because at the time my company's "choice" for health insurance was super shitty for those of us with pre-existing conditions.

banana468 · December 2018

sparklepants41 said:

banana468 said:

I think because your situation would be changing your H can make changes to plans because it's a qualifying event. That's similar to adding a baby or getting married.

Tangent: I FUCKING HATE the penalty clause and think that they're bullshit. It now costs DH and me more money for health insurance because DH and I have full time jobs and we'd pay $1300 to be on his insurance PLUS the additional cost of me on it or I can go through my company's insurance for a slightly different level of care.

Let's not talk about the fact that this is supposed to be offered to all employees and spouses as an equal benefit and now he's essentially not getting something that his coworkers get. Let's not talk about how he works with guys who have wives who CHOOSE to stay at home. And theoretically they have "access to" healthcare if they wanted to buy it on an exchange. And he also works with other people who are married to small business owners or work by contract so they technically don't have "the same access to insurance" but they bring in more money per year. Nope. Let's screw over employees in the name of saving money on an unequal basis. Make it the same or nothing. Don't penalize just the employees with spouses who have jobs.

AMEN. This is H's company as well and we had to take the penalty a couple of years ago because at the time my company's "choice" for health insurance was super shitty for those of us with pre-existing conditions.

I'm lucky that we are theoretically possibly not having more kids so the major benefit of his insurance is not needed for me and my insurance is good enough if I do get pregnant.

But it's something that the company is not acknowledging. He doesn't get any financial credit for me NOT being on his insurance. It's an alleged advertised benefit that is not equal for all employees and I call complete and total BS on that.

short+sassy · December 2018

banana468 said:

sparklepants41 said:

banana468 said:

I think because your situation would be changing your H can make changes to plans because it's a qualifying event. That's similar to adding a baby or getting married.

Tangent: I FUCKING HATE the penalty clause and think that they're bullshit. It now costs DH and me more money for health insurance because DH and I have full time jobs and we'd pay $1300 to be on his insurance PLUS the additional cost of me on it or I can go through my company's insurance for a slightly different level of care.

Let's not talk about the fact that this is supposed to be offered to all employees and spouses as an equal benefit and now he's essentially not getting something that his coworkers get. Let's not talk about how he works with guys who have wives who CHOOSE to stay at home. And theoretically they have "access to" healthcare if they wanted to buy it on an exchange. And he also works with other people who are married to small business owners or work by contract so they technically don't have "the same access to insurance" but they bring in more money per year. Nope. Let's screw over employees in the name of saving money on an unequal basis. Make it the same or nothing. Don't penalize just the employees with spouses who have jobs.

AMEN. This is H's company as well and we had to take the penalty a couple of years ago because at the time my company's "choice" for health insurance was super shitty for those of us with pre-existing conditions.

I'm lucky that we are theoretically possibly not having more kids so the major benefit of his insurance is not needed for me and my insurance is good enough if I do get pregnant.

But it's something that the company is not acknowledging. He doesn't get any financial credit for me NOT being on his insurance. It's an alleged advertised benefit that is not equal for all employees and I call complete and total BS on that.

I agree with you all. Though I've never had an employer who did that. But, alas, it could be even worse. I have worked for a couple companies where the employee had to pay for 100% of the extra monthly premium cost of having anyone else on their medical plan (spouse only or kids only or family plan) .

My friend is a SAHM. Her H's company's offers medical plans for employees only. She and their minor child have to get their medical coverage off the exchange.

ShesSoCold · December 2018

short+sassy said:

banana468 said:

sparklepants41 said:

banana468 said:

I think because your situation would be changing your H can make changes to plans because it's a qualifying event. That's similar to adding a baby or getting married.

Tangent: I FUCKING HATE the penalty clause and think that they're bullshit. It now costs DH and me more money for health insurance because DH and I have full time jobs and we'd pay $1300 to be on his insurance PLUS the additional cost of me on it or I can go through my company's insurance for a slightly different level of care.

Let's not talk about the fact that this is supposed to be offered to all employees and spouses as an equal benefit and now he's essentially not getting something that his coworkers get. Let's not talk about how he works with guys who have wives who CHOOSE to stay at home. And theoretically they have "access to" healthcare if they wanted to buy it on an exchange. And he also works with other people who are married to small business owners or work by contract so they technically don't have "the same access to insurance" but they bring in more money per year. Nope. Let's screw over employees in the name of saving money on an unequal basis. Make it the same or nothing. Don't penalize just the employees with spouses who have jobs.

AMEN. This is H's company as well and we had to take the penalty a couple of years ago because at the time my company's "choice" for health insurance was super shitty for those of us with pre-existing conditions.

I'm lucky that we are theoretically possibly not having more kids so the major benefit of his insurance is not needed for me and my insurance is good enough if I do get pregnant.

But it's something that the company is not acknowledging. He doesn't get any financial credit for me NOT being on his insurance. It's an alleged advertised benefit that is not equal for all employees and I call complete and total BS on that.

I agree with you all. Though I've never had an employer who did that. But, alas, it could be even worse. I have worked for a couple companies where the employee had to pay for 100% of the extra monthly premium cost of having anyone else on their medical plan (spouse only or kids only or family plan) .
My friend is a SAHM. Her H's company's offers medical plans for employees only. She and their minor child have to get their medical coverage off the exchange.

We're like that. My insurance is paid 100% but if I added H, we'd pay 100% of his premium (nearly an entire paycheck for me). It's like half the price to have him go through the marketplace for a lesser plan so that's what we do since his company doesn't offer insurance.

Sucks, but we still save significantly because insurance, no matter who or where you are, is expensive as shit. And I appreciate that I pay nothing for my insurance, which is rare in my experience.

cupcait927 · December 2018

I miss my previous employer's insurance. I had a $12,000 deductible but paid nothing to cover both H and I. They also gave you a $2,600 HSA contribution. I pay less than $100 a month now for H and I but it's a $13,100 deductible and no HSA contribution. Thankful that we have no spousal penalty.

kvruns · December 2018

Thanks all! It ends up I don’t have access until I consistently work 30+ hrs anyway. I’m pretty close but not quite there. Is I have the info for nextvyear

STUCK:

Just to add more context and confusion (and assuming this employer is 50 or more employees), just because you start working 30 hours doesn't mean they will automatically have to offer you coverage. If they convert you to a true FT/benefits eligible position then they would but if you are still a part-time worker who's hours have been ramping up they don't have to offer coverage. In the fall they would then analyze your hours over a 12 month period and if you averaged 30 or more across that 12 months they would make an offer of coverage for the new plan year in January. If you didn't end up averaging that much then they wouldn't have to offer you coverage.

VarunaTT · December 2018

cupcait927 said:

I miss my previous employer's insurance. I had a $12,000 deductible but paid nothing to cover both H and I. They also gave you a $2,600 HSA contribution. I pay less than $100 a month now for H and I but it's a $13,100 deductible and no HSA contribution. Thankful that we have no spousal penalty.

I am officially kissing my sweet sweet $2000 deductible. I don't even remember my catastrophic health insurance that I carried through college having such a high deductible!

charlotte989875 · December 2018

VarunaTT said:

cupcait927 said:

I miss my previous employer's insurance. I had a $12,000 deductible but paid nothing to cover both H and I. They also gave you a $2,600 HSA contribution. I pay less than $100 a month now for H and I but it's a $13,100 deductible and no HSA contribution. Thankful that we have no spousal penalty.

I am officially kissing my sweet sweet $2000 deductible. I don't even remember my catastrophic health insurance that I carried through college having such a high deductible!

$1500 here! (And a $3500 out of pocket max).

But basically nothing besides preventative is covered pre-deductible.

cupcait927 · December 2018

VarunaTT said:

cupcait927 said:

I miss my previous employer's insurance. I had a $12,000 deductible but paid nothing to cover both H and I. They also gave you a $2,600 HSA contribution. I pay less than $100 a month now for H and I but it's a $13,100 deductible and no HSA contribution. Thankful that we have no spousal penalty.

I am officially kissing my sweet sweet $2000 deductible. I don't even remember my catastrophic health insurance that I carried through college having such a high deductible!

What I wouldn't give for a $2,000 deductible. I could enroll in a richer plan, but it would cost significantly more. I'd rather put that money into the HSA. Unfortunately, H has hit the individual out of pocket maximum 2 years in a row ($6,550 and $6650) so we've still spent $12,000+ on his medical treatment, not including any premium. My HSA has taken a beating.

short+sassy · December 2018

Shockers and small wins. This year at my job, they didn't increase the employee portion nor did the deductible increase. But it's still a crappy, high deductible plan.

My portion for employee+spouse is $137.46. No complaints there. Nothing is given toward HSA from my employer. But I choose to max mine out. Though, sadly, I use about 40-50% of that every year, anyway. I feel some of your pain on that, @cupcait927.

Other than the handful of legally required stuff, the medical insurance pays nothing for anything until the ded. is met. Which, in-network, is $4K/person or $8K family. OOP limit is $6400/person or $12,800 family.

Yep, come pretty close to reaching the individual ded. each year, but don't. So it's just always a lot of money I'm paying OOP.

Open enrollment- health insurance question.

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