Lowering Group Health Deductible

[fr-invests]

Hello. I am new to the forum. My name is Frank Rodriguez and I have a quick question regarding group coverage. If a group lowers their group deductible and lets say there is a pre-existing condition (say, pregnancy), can the insurance company deny the claim or are they still bound to coverage?

I got this question thrown at me by an insured - I am NOT a group health agent. Thank you in advance.

Frank -
Naperville, IL

 

[somarco]

Why would an employer want to increase premiums? Makes no sense.

But to answer your question, if this is truly a group plan, not some hocus-pocus association plan for nice employers, the carrier is obligated to pay the claim, including pre-ex conditions.

Usually changes like that are made at anniversary or the end of the calendar year. If the employer wants to lower the deductible mid year you know the carrier will look at ongoing claims an price accordingly.

 

[moonlightandmargaritas]

Geez, who can afford to lower the deductible these days?