Dropping Kaiser for Aca?

[PhxSunsFan]

Rusty on IHP.. friend has kaiser thru her county job in so cal.. Might need brain operation , and Kaiser has her waiting 3 weeks just to go over her mri results.. can she drop kaiser thru work and pay her own great plan via aca and keep it until she decides she wants to go back to her kaiser fully paid plan?

 

[STIBROKER]

. can she drop kaiser thru work and pay her own great plan via aca and keep it until she decides she wants to go back to her kaiser fully paid plan?

sorry no..........unless she has a sep she is sol..........

 

[rcduggan]

Rusty on IHP.. friend has kaiser thru her county job in so cal.. Might need brain operation , and Kaiser has her waiting 3 weeks just to go over her mri results.. can she drop kaiser thru work and pay her own great plan via aca and keep it until she decides she wants to go back to her kaiser fully paid plan?

first, her kaiser plan through work will cost less for richer benefits. the services needed she probably already has used some monies this past 7 months on her current plan and applied to her out-of-pocket which she would not be able to apply if she changed carriers or went IFP.
i'm a little confused when you say "plan via aca". technically speaking she could drop her group plan and it would trigger a qualifying event opening the door to the IFP market. REGARDLESS how much her income is she will NOT receive subsidies because she has been offered an employer group plan. if you simply mean move to an IFP plan on/off exchange will then sure but what i said above about out-of-pocket costs applies. furthermore, she will only be able to re-apply to the work plan during the company's open enrollment.

i am not even touching on the fact of if she were to change carriers from kaiser to ANY other carrier, she would need new doctors, them updated on her records, and everything in place for this surgery. please try and understand the impact of this last bit.

i am also not knocking her by any means for having kaiser, but this is a prime example of how kaiser operates. i've seen situations like this way too many times in my career.

county job in california CalPers should be an option and blueshield other than kaiser but this isnt much help at the moment

 

[kgmom219]

i'm a little confused when you say "plan via aca". technically speaking she could drop her group plan and it would trigger a qualifying even opening the door to the IFP market. REGARDLESS how much her income is she will NOT receive subsidies because she has been offered an employer group plan. if you simply mean move to an IFP plan on/off exchange will then sure but what i said above about out-of-pocket costs applies. furthermore, she will only be able to re-apply to the work plan during the company's open enrollment.

Just to clarify:

Are you stating that an employee can voluntarily drop their group coverage mid-year, while remaining employed, and that triggers an SEP for an Individual Policy?

 

[Yagents]

She can quit her job and get an SEP. But cannot voluntarily drop her group and get an SEP. She has to stay on Kaiser until OEP for IFP or her group.

It would have been the same way pre-ACA, she would have been stuck on Kaiser as her pre-ex would disallow a private plan.

Seems like this feature wasn't fixed with ACA.

 

[Josh]

I'm sure it might be different, but my daughter has Kaiser and after around a million in claims including two brain surgeries, we couldn't be happier with the care Kaiser has been providing my now 17 month old.