Cancel employer provided Insurance?

[nanato2]

What is the name of your state (only U.S. law)? Mississippi

Can an employer force my daughter to continue paying for health care, that she can no longer afford?

Half her paycheck goes to Health insurance prem.--she has lost her roommate, and has two small children.

Her employer says she must keep the coverage until the company enrollment period, which is in Feb.

They will all be homeless by then.
Can they FORCE her to keep paying these premiums?

Every claim she has filed has been rejected as pre-existing, so they are not helping the children, anyway.What is the name of your state (only U.S. law)?

[CourtClerk]

She has to wait until open enrollment to make changes to her insurance unless she experiences a qualifying event. Losing her roommate is NOT a qualifying event.

[nanato2]

Thank you, CourtClerk.

Can you tell me what would qualify as a life event, other than marriage, or divorce.
Her policy states marriage, divorce, OR a change in domestic partnership, birth of/death of a child, etc.

I know we are stretching, but since they are listed separately, if this
doesn't qualify as "a change in domestic partnership", what would?

I probably already know the answer to that one!ha

[CourtClerk]

Originally Posted by nanato2

I know we are stretching, but since they are listed separately, if this doesn't qualify as "a change in domestic partnership", what would?

A domestic partnership is a legal term that does not include "roommate." It generally refers to 2 people of the same sex that are registered as "spouses" or (in some states) common law spouses.

Your daughter will have to make due until she can change coverage.

[nanato2]

Thank you for your responses.

[ecmst12]

Losing her roommate would have to affect her insurance coverage, meaning they were on the same policy. That is not an option in most cases for people who are merely roommates and not domestic partners.

When she signed up for the insurance, she agreed to have it for the entire year. Employer sponsored group health plans are governed by very strict federal laws because of the tax-exempt status of the premiums. There are no exceptions to the open enrollment rules.

[nanato2]

Now, that last post (sorry, I didn't catch your name)
is very informative, and puts an end to her hopes of getting a different answer from any type of Insurance Commission.

She was living with us, at the time she started the job, and applied for the insurance, but that just could not continue.
She can't get any assistance from the state because her gross pay is the qualifier, not after insurance.
She has two special needs children, and I was really STUPID, to push her to apply for the best coverage the company was offering.

Can she maybe REDUCE her coverage, thus reducing the premium,
or would that have to be done during open enrollment, also?

[CourtClerk]

Originally Posted by nanato2

Can she maybe REDUCE her coverage, thus reducing the premium, or would that have to be done during open enrollment, also?

Changes may be made (including canceling insurance) during open enrollment only, unless there is a qualifying event. So no, she cannot reduce coverage until open enrollment.

[ecmst12]

Hopefully she can find another roommate quickly.

[cbg]

And just to confirm, we are talking Federal law here. This is not the employer being obstructionist.

[nanato2]

Thank you all.

My daughter's landlord agreed to work with her as much as possible.

He is being very kind, and we will just have to pray for a responsible roommate to appear, before she gets in TOO deep.

Thanks, again

[TIMMAAYY]

I am checking into something based on some recent news I received regarding ERISA and employee participation. I have not heard any word yet regarding "qualifying events" or "open enrollment" with respect to making changes or dropping/adding, but I can tell you that there was a recent ERISA opinion made that might be the holy grail of those who think they are stuck with group insurance because of participation rules. I'll keep you posted.

[nanato2]

Thank you, Timmaayy.

I can just hear my neighbor calling her son...back in the old days, when it was safe for children to wander the neighborhoods:
"Timmmmaaaayyyyy!"
Anyway, I have sent you a private message, with my e-mail address, so please let me know if you find any loophole, or whatever that might help us.

Thank you, thank you, thank you!!!

[TIMMAAYY]

It's not a loophole. It's a recently issued ERISA opinion that could be helpful to you if your daughter can get other health insurance elsewhere that is less costly. ERISA is federal law and supersedes state laws.

[nanato2]

That is great news, for more than just my family!

Now, this is probably pushing it to the extreme, and I have not YET
shopped for ins.quotes, but am curious:
she would easily qualify for the state CHIPS program. Is that an option?
I know that she would have to be without insurance on the children, when she applies for CHIPS, so
if she has to GET the less expensive insurance BEFORE she can get out of the other, that alone would take that option off the table.

So, my question is: Does the state Children's Health Insurance Program qualify ?