open enrollment laws for supplemental health insurance

[necessary]

What is the name of your state? SC

I was told by my new rep ( old one left) for supplemental health insurance that it is federal law that I be contacted during open enrollement to discuss the policy I have, and if I wish to make and changes in it. However, my old rep never did this, she said my employer wouldn't allow her to. I can't find any law anywhere stating that this is a federal insurance regulation. Does anyone know if Supplemental Health Insurance providers ( i.e. Aflac ) are required to contact each customer during open enrollment? I noticed on the Salaray Redirection Agreement that I signed that it states that I will be afforded the opportunity to discuss and change my policy every year, but I can't actually find a LAW that states that. Can someone point me in the right direction? Thanks sooooooo much.

Stephanie

 

[cbg]

If your rep is under the belief that each and every member must have a consultation during open enrollment, he or she is mistaken. About the only requirement I know of under Federal law is that the members must be made aware that it is open enrollment and that they can make changes if they want. Unless there is something VERY different in the law for supplemental insurance, which I doubt, a letter stating that open enrollment is between xx/xx/xx and yy/yy/yy and these are the changes you can make between those dates, is sufficient. No personal consultation is necessary.

 

[necessary]

law

Do you know where I could find that law? I have received absolutely nothing in the past 2 years, not even a copy of my policy.

 

[cbg]

I believe the law you're looking for was part of the original HIPAA. Not the new amendment that just went into effect in April, but the original law.

Mind you, I'm not certain that supplemental insurance is covered under HIPAA. And if it isn't, then there's no Federal law regarding open enrollment at all, and there's no requirement that there even BE an open enrollment.

 

[necessary]

From what I have read it seems HIPAA is aimed more at group insurance plans and your rights when transfering jobs: keeping insurance, pre existing conditions, what is mandatory to cover etc.
I did find mention that title II of HIPAA deals more with the Administrative side of insurance regulations, so I would imagine that Open Enrollment regulations would be covered under that, but I can't find title II on the net. To be honest, I can't find anything but summaries of HIPAA period.

I have doen searches looking for any regulations on open enrollment, and I find mention of them existing, but no concrete laws or regulations on what insurance companies must do for open enrollment, it's frustrating.

It seems to me that if such rules and regulations existed, it really shouldn't be a problem finding them. If anyone else has any other suggestions on where I can look, or things to search for, sites to visit, etc. Please let me know. Thanks
Stephanie

 

[cbg]

Stephanie, let me ask you a question. What is your goal here? Is it just to find out what the insurance company is required to do? Or is there something you would have wanted to do that you feel you did not get the opportunity to do because of the confusion over open enrollment? If so, what?

Depending on which it is, I may have a possible suggestion for you.

 

[necessary]

Let me make this as short of an answer as possible, I could seriously write a novel on this. I signed up for AFLAC almost 2 years ago. I was under the impression I was signed up for a personal accident expense plan to help cover hospital deducts, and a personal short term disablity plan b/c I was about to be married and hubby and I wanted kids ASAP.
It took a while but I became preg (woohoo) I called AFLAC to let them know I was pg - my new rep told me I wasn't on short term disabilty plan( which covers maternity) I was on off the job accident short term disabillity. I hunted down original rep ( moved to diff state) she said she was sorry I was signed up on a diff plan than I thought I was. She mentioned that if my company allowed for her to visit with me during open enrollment all of this could have been solved then, b.c she would have to go over all plans I carry and ask if I wanted to change, but my employer wouldn't allow it. I verified that with my benefits co-ordinator at company. I called orig rep and visited diff local office and spoke with manager they both told me it is fedl aw she has to contact me during open enrollment for changes, etc and that actually my company could be in trouble too for not allowing it(if they got audited).
So, I mailed letter CRRR to Aflac explaining everything, asked them to put me on the correct plans and that I wanted to pay for the difference for me to be on the right plan for past 2 years ( 438.48). Just got green card back saying they got it. Just curious if they dont' out of good will of heart (ha ha ) change me to correct plan, is there some other recourse I have.
I hope that was short enough. Sorry thanks for all advice and help.
Stephanie

 

[cbg]

Okay, Stephanie, I think I understand now. I'm going to do some research. Because of the weekend and because I'm going to be travelling on business for part of next week it might be as long as a week before I get back to you, so don't think I've forgotten.

 

[necessary]

Thank you so much!

 

[necessary]

Have you thought of anything yet?

 

[cbg]

I haven't forgotten you, but I haven't found the answer I'm looking for yet either. I'll keep trying and let you know as soon as I find it.

 

[Bigfoot]

Is anything about the supplemental coverage in your employee benefits booklet? If your employer is not paying any of your supplemental coverage, you may find that you could be paying this policy independently and you would have an actual policy, instead of an explanation card.

It helps AFLAC to get a regular check from your employer instead of depending on you to make your regular payments. The exception is that using your employer allows you to use pre-tax dollars to pay your premiums if your employer has allowed this.

So your two biggest missing pieces are an actual policy and an employee benefits booklet.

 

[necessary]

thanks CBG
BigFoot: Nothing about Supplemental Ins in Benefit book. Company doesn't cover any of it. I pay for all of it. 1 policy pre tax, the other after tax. My employer deducts amounts from check bi weekly and they actually send in money to AFLAC. AFLAC was supposed to send me a policy outline/book when I signed up, but I still haven't gotten one, and that was over a year and a half ago.

 

[cbg]

Quick question to help me out here. Is there supplemental health insurance AND disability (two policies) or just disability (one policy)?

And are the deductions taken out of your check pre-tax or post-tax?

 

[necessary]

2 policies
1 Supplemental-called personal accident expense plan
1 disability ( im signed up for off job accident disability rider- I wanted short term disability rider)
Steph