I’m not able to drop wife’s job health insurance. Help please.

kyotodragon

New member
Details

My wife is a teacher with a public school district in Texas USA. She has a family health insurance plan subsidized by the school with enrollment available during early fall every year.

On Dec 12, 2021 Family health insurance began at my place of work that is superior and cheaper. We pay $900 per month for my wife’s insurance and zero for mine. The $900 is deducted from her paycheck which is issued once per month.

Neither of us have much experience with health insurance as we went most of our adult lives without any.

Around Dec 15 my wife emailed the district’s benefits admin with A request to drop. She was told that was fine as long as the my insurance started in the past sixty days and we needed to provide some thing that showed the effective date of my new insurance plan.

I sent a couple of documents that I thought would suffice but they did not. They were printouts of a webpage but were not specific enough to show the Dec 12 effective date.

Our whole household got Covid around Jan 1 and we’re sick for weeks. This is probably not relevant.

On Jan 20 I called my plan provider and requested they send an appropriate certification to the admin‘s email address and my email address. This is documented in their notes.

On Jan 26 that certification document was produced but it was not emailed to either of us. I was not informed of this and as I was sick I did not proactively follow up. In my mind I had taken care of the issue.

On Feb 16 while on my health plan website I thought to follow up on the document but could not find that I had received it in email. I called and my rep said that it had been produced but it was unknown why it was not sent. While on the phone, the rep emailed it to me and showed me where to download it on the web portal.

I immediately sent the school district admin the document.

We are now told that because the documentation we provided was past 60 days from the Dec 12 plan start for my job, that they will not cancel my wife’s plan due to IRS regulations.

My plan provider is willing to issue a letter stating the facts found in the call notes including the date of the request and the date of the issuance and the fact that it was not emailed as requested. I don’t know whether this would be helpful or not.

As it stands we cannot drop my wife’s plan that represents an extra $900 for us monthly. You can see why this would be troubling and I’m looking for any advice or course of action that would help our situation.

Thank you
 
@kyotodragon
My plan provider is willing to issue a letter stating the facts found in the call notes including the date of the request and the date of the issuance and the fact that it was not emailed as requested. I don’t know whether this would be helpful or not.

This is worth a shot. It'll be submitted to your wife's insurance company for retro-review (this can take a few weeks to complete), but I've definitely gotten changed approved in cases like this before.

Make sure you follow up about once a week or once every other week.
 
@kyotodragon Spouses usually cost more than the employee on the same plan. Make sure you confirm how much the new/secondary coverage will cost before starting the transition. And government plans can be better than private so comb the details.
 
@necronomic It’s a union job. Zero premiums for all dependents. Nothing is deducted from my check. It’s a virtual raise as we should now be able to keep the $900 premium in our pockets.
 

Similar threads

Back
Top