Adding Spouse to Group Health Plan
I have health insurance through my employer. My wife has health insurance through her employer, but we are planning on starting a family after the first of the year, so she will lose her insurance. I talked to my employer about adding her to my coverage so she would have insurance already in affect when she leaves her job. They told me that I can’t add her until June, something about an open enrollment. What do we do if she wants to leave her job at the end of February? I know she can take COBRA, but my employer will pay for her on our group plan, but won’t pay for her COBRA, that is why I wanted to add her now.
The addition of a dependent to an existing group health plan must usually be done during open enrollment, but there are exceptions to this rule. A newborn child, or a newly adopted child, may be added to your group health plan at any time. The same holds true for a new spouse. And, another exception is a spouse that has lost their current health insurance. So, once your wife leaves her current employment, she will be given the option to continue on that plan under COBRA. A COBRA option letter will be mailed to her shortly after her group coverage terminates. This letter can be presented to your employer, who will then submit it to your insurance carrier as proof that she is eligible to join the group health plan outside of the open enrollment period. There may be a 30 day lapse in coverage, during which period you may want to pay her COBRA. This is because you won’t be able to add her to your group plan until you can prove that she has lost her coverage, and then she will be added to your policy on the first day of the following month. She will have 60 days to accept her COBRA option, which will give you plenty of time to make certain that she will be covered under your employer’s group plan. You can verify this with your employer or insurance company and also ask them if there is any other way that she can be added to the policy without a lapse. One way that might work is to have her give notice in the middle of the month, so maybe she can get the COBRA option letter soon enough to provide proof to the new insurance company and avoid the 30 day lapse in coverage. Your employer or insurance company should be able to better inform you on how to make this transition more immediate.
I wanted to add some more information for the people out there who share the same situation as stated in the original question, which is that they have an option to add their spouse to their group health plan. If your employer will pay the full cost for your spouse then that’s great, but if they don’t, you may be surprised at the cost of getting coverage for your spouse. It’s really not that unsual for the employer to pass on the full cost to the employee. I was recently quoted 700$ monthly to add my wife. I initially thought this was quite expensive even for a high end plan, but it turns out that this inclusion would be for my entire family and not just my wife. I used to be covered under ‘employee only’ but with the inclusion of my wife I jumped to ‘family’, with no option in between. This means that I pay a flat rate, no matter how many dependents I add. So if you are in this situation remember to check if you are covered under ‘employee + 1′ or ‘family’ plan.
Comment by James — May 24, 2009 @ 9:18 am