Couple of Questions on Group Health

Jul 6, 2008

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  1. padthaiforlunch
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    padthaiforlunch Guru

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    I've read a couple of threads that suggest different answers and I am still unclear. So, if you please....

    1. Pulling an individual or their family off of group plan after enrollment period closes. Doable? If so, how hard, easy?


    2. A friend is referring a small group (20). They are currently insured, but for whatever reason don't like ther carrier. Is it ok to switch carriers mid-year? If so, what factors need to be considered to stay compliant with sec.125? And what are the consequences of non-compliance?

    Thanks!
     
  2. STIBROKER
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    STIBROKER Like My post and enter the DRAWING,,,, Moderator

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    yes and yes......
     
  3. GreenSky
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    GreenSky Guru

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    I don't understand why you always need so many words to answer questions. Simply stated:

    Yes. Yes.

    See? It only needs two words not a total waste of bandwidth and time for you to write three words.

    One day you'll thank me for helping you out. Please don't waste our time with posts that can be summed up quickly.

    Rick
     
  4. somarco
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    somarco That Medicare Expert Guy

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    OK, has something changed?

    An enrollment period indicates (to me at least) there is a 125 plan in place. Employees are not allowed to make changes in their coverage outside of the enrollment period absent a qualifying event.

    If the plan is not administered under 125 changes can be made at any time.
     
    somarco, Jul 6, 2008
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  5. padthaiforlunch
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    padthaiforlunch Guru

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    Well, that makes me question the earlier responses....

    So, to take a a little more bandwidth, how about group plans? If you can swap carriers anytime during the year, then why do you ask and wait until renewal period to vie for the business?
     
  6. padthaiforlunch
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    padthaiforlunch Guru

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    Why do you have to be so nasty?
     
  7. LGilmore
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    LGilmore Guru

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    1.Pulling an individual or their family off of group plan after enrollment period closes. Doable? If so, how hard, easy?

    Who is paying the premium? If the employee is paying the premium for dependents, they can drop at anytime (usually the following month). All they have to do is claim hardship..done. The trick is they can't come back as easily. They would in most cases have to wait until a qualifying event or open enrollment. It will depend on a carrier's rules.

    For the employee, if company is paying freight, it may be up to the company. If yes, a waiver must be signed off on releasing company of liability.


    2. A friend is referring a small group (20). They are currently insured, but for whatever reason don't like ther carrier. Is it ok to switch carriers mid-year? If so, what factors need to be considered to stay compliant with sec.125? And what are the consequences of non-compliance?

    You can switch carriers at any time in most cases. It will depend on the type of plan being used. Most likely because this is a small group plan, not a problem.

    Section 125 has ABSOLUTELY no requirements that force a company to stay with any carrier. Plans are amended all the time. Section 125's are created and stopped all the time.
     
  8. djs
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    djs Super Moderator Moderator

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    Terminating a group plan off-cycle may costs a termination fee. Also, if not handled properly, may costs employees $$$ spent towards deductibles.

    Both of these can be dealt with, just make sure the client acknowledges the termination fee (if it exists) and that the new carrier will give credit for payments towards deductibles that have already been paid.
     
    djs, Jul 6, 2008
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  9. padthaiforlunch
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    padthaiforlunch Guru

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    Very cool.

    Thanks guys!
     
  10. ABC
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    ABC Guru

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    Most controllers do not want to deal with health insurance during the middle of the year unless they are in cost cutting mode. Now if you can get in the door mid year and save 20% that can help you get a new client. 20 life groups are nice hits:)

    The employee can drop the group coverage at anytime on small group.
     
    ABC, Jul 7, 2008
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