Can My Sister-in-law Be Denied for Maternity on a Group Plan?

[ABC]

If you had opened your eyes and fully read the first post, I DO NOT SELL GROUP HEALTH. I do not know how it works or the ends and outs of it. Furthermore, I mostly do p&c and life. I sell maybe 1 health policy per month. So I will readliy admit that I do not know anything about group health coverage.

I personally would not be so rude if someone who only sells life and health went over to the p&c forum and asked a legit question.

Here is idea for you. Check with the carrier. Call the carrier ask for group services and ask your question.

Here is another idea call the DOI and ask them the state laws for small and large group regarding maternity.

Be sure to write down who you speak with and what they say and also date it.

You can call me rude but I would call you incompetent / lazy

 

[popeye35]

Here is idea for you. Check with the carrier. Call the carrier ask for group services and ask your question.

Here is another idea call the DOI and ask them the state laws for small and large group regarding maternity.

Be sure to write down who you speak with and what they say and also date it.

You can call me rude but I would call you incompetent / lazy

Those are both good ideas (calling the DOI especially). I guess you could say it is lazy, but I figured if someone on here could tell me, I would appreciate it. Furthermore, they are not my customers, so I was just trying to do them a favor. I've now told them to call their carrier and now I will tell them to call the DOI to find out. As a matter of fact, that is probably the best place for them to call, so thank you for the advice!

 

[Prouddad]

I agree with Dayton, with one exception that may not apply here. I believe that if the re-hired (and thus new) employee applies within the proper window for application, she'll have no problem getting her pregnancy covered. Problems begin with pre-existing conditions however, when you enroll AFTER your enrollment period has ended. Then, carriers don't have to cover pre-existing conditions for 6 months.

I don't believe that a group disability plan has the same guidelines as a group health plan, but I'd check with the HR person. Perhaps she can convert the group plan to an individual plan since she's leaving.

 

[DS4]

This is from the Dept of Labor web site,

Are there illnesses or injuries that cannot be subject to a preexisting condition exclusion?
Yes, as follows:

• Pregnancy, even if the woman had no prior coverage before enrolling in her current employer's plan.