Wife's insurance backdated adding me as a dependent and is charging hundreds for the privilege
This is in Idaho. My wife and I were married in late July. For most of the rest of that month and all of August, she tried to add me onto her company insurance plan, but was unsuccessful because the app she had to use to do so would error out on every attempt. When the special enrollment period was coming close to ending, we reached out both to the company providing the insurance as well as the people within her company that were supposed to handle the internal side of things. She was told that she needed to submit a claim for an appeal and that she would be contacted at a later date. Roughly a week and a half later she was called back and allowed to add me onto the plan, that it would be effective immediately, and we thought that was that. Cut to almost two weeks later and she gets her paycheck that has an extra couple hundred dollars taken out for insurance over what we were being told the new premiums would be. Upon reaching out she was told they had backdated the policy to the date that our marriage certificate was signed and the extra charge was for that. This was frustrating enough as we made what attempts we could to try and correct this and in the process discovered that the same additional charge will be applied to her next 3 paychecks, potentially leaving us unable to pay most of our upcoming bills and they are refusing to fix anything in our favor because it's "company policy" that submitting an appeal causes a new spouse's insurance to be backdated in this way.
At first my wife was pretty certain that when they called her and changed the policy, that she was rushed through the process and wasn't really given many details, particularly about the backdating issue. Now she is thinking she may have been distracted and just missed it at the time. I'm not sure if there's any way to obtain the recording of the call, so I have no idea what the truth is.
I'm a little at my wits end about the situation because they're now giving us the option to either keep things as they are and continue with payments that I don't think we can afford, or to cancel adding me to the policy entirely, leaving us straddled with the cost of meds I desperately need that I know we can't afford. I don't know what to do and need whatever help we can get.
Wife's insurance backdated adding me as a dependent and is charging hundreds for the privelege
byu/Master_Nose_1638 inInsurance
Posted by Master_Nose_1638
3 Comments
Aside from the hiccup of the enrollment not processing on time, this is pretty standard so I’m curious what you expected to happen?
The policy change was effective the date of marriage, so that is when you are effective on the plan.
This means the plan converts from employee only to employee and spouse.
Adding a spouse means the premium surcharge is higher.
There will be a disparity between back premiums owed so you have retroactive coverage and the regular EE/SP surcharge going forward.
Privilege? Honestly you should be thankful they processed the coverage so you didn’t have to wait for open enrollment, but did you think this would be *free*?
Nothing you described sounds crazy unusual. What is the previous premium and the new premium? My guess is that the big increase is because the company is not subsidizing the spouse’s insurance – this is common
With health insurance enrollment there are basically two choices legally speaking. Either they cover you from the day that attempting to process the change starts or they don’t.
If you are covered / add coverage then they earned your premium for being exposed to the possibility of taking on claims and losses from covering you as of that change date. If you are not covered / remove coverage then you are not charged or get a refund if you were charged.
This applies no matter how long it takes to fully process the change. So once you start adding yourself to a benefit plan you also have to start setting aside the funds to pay for it.