cancelling health insurance

[I need help5234]

What is the name of your state? Virginia

I enrolled in my companies health insurance plan at the time I thought that I was enrolling in the EPO plan. But to my surprise and my dismay the PPO plan was the box that I marked. Due to my fault and the fault of my HR department. The situation occured as I was running out of my home. I advised them over the phone that I did not have my paperwork with me and that I was sure it was the plan on the left hand side of the paper that I wanted. The peice of paper that I was thinking of did have the EPO plan on the left hand side of the paper. The peice of paper that they looked it was the PPO plan.
Regardless there was a mistake made, now I am being told that I will have to come up with 500.00 before my baby is born as part of the ppo they only pay for 90% of the pre natal care. Then my husband and I are going to be responsible for another 10% of what ever the child costs.

The reason that I joined my companies insurance and wanted the EPO plan was because my husband lost his job, and we found out that we were pregnant all about the same time.

The HR dept. at my work has advised me that there is nothing they can do to change the plan since it is a pre tax deduction and that it is an IRS issue. I have called the insurance bureau, and also the IRS neither one sees any reason why they can not change it. Is this just a case that the HR department is to lazy, my husband will be going into the coast guard active duty soon. I would rather cancel my insurance then have to pay all of these fees since this is not what I really wanted. Basically the only way that they will let me out of this is if I quit my job. Please help!

 

[cbg]

No, this is not a case of the HR department being lazy. What they told you is literally true. Because your portion of the premiums are taken out pre-tax, there are VERY rigidly controlled regulations, at the Federal level, as to when you can or cannot make changes, or add/drop coverage.

The IRS is not the regulatory agency for this issue, which is no doubt why they didn't know the correct answer. The DOL is, and they would have told you that changes to a Section 125 plan (which is what you are under if your share of the premium is taken out pre-tax) can ONLY be made at open enrollment time. This happens once a year. Specifically when within the year depends on when your particular plan renews. The same law restricts you from dropping coverage except at open enrollment, or when you leave employment. The ONLY exception is that you will be able to add your baby, after it is born, to the plan as long as you enroll him/her within 30 days of its birth. DO NOT assume that HR knows you want the baby covered. They cannot add the baby without your specifically saying so, and in 9 cases out of 10 your completing the appropriate forms. (A similar exception would be made in the event of marriage, adoption or divorce.)