SEP Question MAPD/Group Coverage

[insurance0707]

I have a couple that are paying close to $500 a month for their Teamsters group coverage. They would like to switch over to a MAPD plan for $100 a month. We submitted the app and the MAPD company said "No" they can't join now they have to wait until AEP. From what i've read they do have a SEP "EGHP" that states they can leave group coverage either voluntarily or involuntarily and join a MAPD or a Med sup and a PDP......has something changed for 2010?

 

[GreenSky]

Never had a problem with this. CMS will require proof that the group plan was creditable for Part D and a copy of the cancellation.

But it is a valid reason for an SEP.

Rick

 

[insurance0707]

Thanks for the info Rick....I wasn't sure if it had changed for 2010
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just got off the phone with the insurance company, they said that they would have to do it during the Teamsters Open Enrollment period. Does anyone know if the Teamsters even have an open enrollment period?

 

[Josh]

Thanks for the info Rick....I wasn't sure if it had changed for 2010
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just got off the phone with the insurance company, they said that they would have to do it during the Teamsters Open Enrollment period. Does anyone know if the Teamsters even have an open enrollment period?

Usually group stuff is annual at the end of the year or in the middle of the year.

Technically it's only supposed to be if it was an involuntary loss of coverage, but CMS has no good way of policing that.

 

[insurance0707]

on the code for SEP it states voluntarily or involuntarily losing group coverage. they can't force a person to keep their group coverage. I've come across some people that are being charged $1,000 - $1,500 a month....they just couldn't afford it