Group health insurance - Does it cover pregnancy?

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PostPosted: Tue Feb 23, 2010 10:42 am   Post subject: Group health insurance - Does it cover pregnancy?  

My employer is about to remove me off the group health insurance coverage. Is there a way out!

I just wanna remain covered under the same policy while I'm pregnant.


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Rebeccabrown
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PostPosted: Tue Feb 23, 2010 12:39 pm   Post subject:   

What do you mean about to remove you? Why?



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PostPosted: Wed Feb 24, 2010 11:30 am   Post subject: Group health insurance  

Yes, there are some group health insurance policies that cover maternity. If your employer wants to remove you from the group health policy, you'll have to look for individual policy. You can also enroll in COBRA plan.

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PostPosted: Wed Feb 24, 2010 10:27 pm   Post subject:   

Quote:
My employer is about to remove me off the group health insurance coverage.




I am not aware of ANY state that will simply allow an employer to "remove" a person from a group medical expense plan. It can't be done. The only way that I am aware of that an employer can "remove" a person from any group plan is if the employee is no longer eligible for that plan. The common reasons for an employee no longer being eligible are (a) you no longer meet the definition of full-time employee as many plans only include full-timers, or (b) the group plan is being terminated in it's entirety.



That's about it. Could you give us the reason that your employer gave you for attempting to do this? Is this a true group plan or are these individual plans that your employer is paying the premium on?



Give us a little more info and we can be of more help. By the way, maternity costs are almost always a required coverage in a true group insurance plan. Individual plans may or may not provide maternity coverage- depends on the plan.



Veronica- please remember that COBRA is only available to employers with 20 or more employees and that the insured must have been in the group plan for a period of time in order to be COBRA eligible.



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PostPosted: Thu Feb 25, 2010 10:59 am   Post subject:   

Quote:
You can also enroll in COBRA plan.


Yes, you could now have Cobra coverage. I guess you could also have mini-cobra. It probably covers people who've got out of a group plan (for about 18 months). You may ask your employer regarding the various options that you could choose from.
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PostPosted: Fri Feb 26, 2010 6:28 am   Post subject:   

I guess there are laws that protect the pregnant women from being exceptions at the work place. If the pregnant employee's coverage has to be dropped, then all others should also lose their coverage. I don't think they can keep the other employees covered under the same policy while dropping only one of them.

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PostPosted: Fri Feb 26, 2010 6:57 pm   Post subject:   

Quote:
don't think they can keep the other employees covered under the same policy while dropping only one of them.




They can't. Federal saw (ERISA that deals with "Welfare Benefit Plans") and state law prevent "cherry picking" by employers and insurers. If they were allowed to pick and choose which employees are allowed into the plan and the insurer was allowed the same right, they would only be picking the healthiest employees to allow in the plan. Less losses equals higher profits.



States will NOT allow this. Oh yeah...what happened to our original poster? Arghhhhhh...



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PostPosted: Sat Feb 27, 2010 7:21 am   Post subject:   

It's true that it won't be possible for him to drop only you out of this plan.

Don't you qualify for a state program? Also, check if you'd satisfy the FMLA requirements.

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PostPosted: Sun Feb 28, 2010 1:51 am   Post subject:   

Is it possible that she took off early (too early) for her delivery. They covered her up to the point they had to and then it is on her and COBRA costs too much? Not sure of the laws with this....just a thought.



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PostPosted: Mon Mar 01, 2010 6:08 pm   Post subject:   

They may have a management carveout group plan?

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