I am a bit confused with a conversation I just had with an underwriter. State of TN.
I have a 66-year old guy with A & B who is still working who left his job to take a new one recently. He lost his employer-based coverage from his previous employer 1/31/16 when he left active employment. He doesn't want to pay for COBRA because it is like 1200 a month for he and his wife.
I submitted a GI application for an F for him. I attached the certificate of continuous coverage from his previous insurance company. He doesn't have the COBRA package yet, was a big hassle to get the COCC from his former employer which is why I didn't submit app until end of February. I get a call from an underwriter asking why he is no longer covered and saying that they need a letter from his employer with the reason that coverage terminated. I state, ok, he left employment and took a new job, that is why the coverage terminated. I ask if the COBRA package would suffice when he gets that, he isn't sure of the time frame when it will come.
She puts me on hold and comes back and says it is not GI because he left his coverage voluntarily. I am confused. He didn't leave the coverage voluntarily, he left the job voluntarily. He would have loved to stay on this very good plan with awesome drug coverage instead of the Part D with donut hole, but unfortunately they won't let him since he no longer works there.
I thought this "voluntary" part only applies to someone voluntarily leaving retiree coverage (that they are otherwise still eligible to continue) OR voluntarily leaving an employer's coverage even though they are still an active employee and otherwise eligible to continue it. I did not think the "voluntary" bit ever applied to when employment terminates, regardless of the reason for termination.
The underwriter stated to me "if the person had retired, it would have been GI, but it isn't GI because they left to take another job". So, if someone works after 65 and leaves a job to take another job, this is not a GI situation, but if they "retire" then it is?
That doesn't make any sense to me. What is the difference between retiring and changing jobs? I think the underwriter may be wrong about this, but wondering where I go from here.
This guy could be put with UHC if it comes down to it for more money. But of course, I would look like an *** who didn't know what they were talking about.
I am getting used to that, though.
I have a 66-year old guy with A & B who is still working who left his job to take a new one recently. He lost his employer-based coverage from his previous employer 1/31/16 when he left active employment. He doesn't want to pay for COBRA because it is like 1200 a month for he and his wife.
I submitted a GI application for an F for him. I attached the certificate of continuous coverage from his previous insurance company. He doesn't have the COBRA package yet, was a big hassle to get the COCC from his former employer which is why I didn't submit app until end of February. I get a call from an underwriter asking why he is no longer covered and saying that they need a letter from his employer with the reason that coverage terminated. I state, ok, he left employment and took a new job, that is why the coverage terminated. I ask if the COBRA package would suffice when he gets that, he isn't sure of the time frame when it will come.
She puts me on hold and comes back and says it is not GI because he left his coverage voluntarily. I am confused. He didn't leave the coverage voluntarily, he left the job voluntarily. He would have loved to stay on this very good plan with awesome drug coverage instead of the Part D with donut hole, but unfortunately they won't let him since he no longer works there.
I thought this "voluntary" part only applies to someone voluntarily leaving retiree coverage (that they are otherwise still eligible to continue) OR voluntarily leaving an employer's coverage even though they are still an active employee and otherwise eligible to continue it. I did not think the "voluntary" bit ever applied to when employment terminates, regardless of the reason for termination.
The underwriter stated to me "if the person had retired, it would have been GI, but it isn't GI because they left to take another job". So, if someone works after 65 and leaves a job to take another job, this is not a GI situation, but if they "retire" then it is?
That doesn't make any sense to me. What is the difference between retiring and changing jobs? I think the underwriter may be wrong about this, but wondering where I go from here.
This guy could be put with UHC if it comes down to it for more money. But of course, I would look like an *** who didn't know what they were talking about.
I am getting used to that, though.