• FreeAdvice has a new Terms of Service and Privacy Policy, effective May 25, 2018.
    By continuing to use this site, you are consenting to our Terms of Service and use of cookies.

Recently married before Wife Surgeory, insurance fraud?

Accident - Bankruptcy - Criminal Law / DUI - Business - Consumer - Employment - Family - Immigration - Real Estate - Tax - Traffic - Wills   Please click a topic or scroll down for more.

Preview What is the name of your state? Florida My wife discovered she needed a surgeory in July th

  • Yes

    Votes: 0 0.0%
  • No

    Votes: 0 0.0%

  • Total voters
    0

Smd09

Member
What is the name of your state? What is the name of your state? Florida

Back in July, my wife discovered she needed a surgeory that would cost a pretty penny with her high deductible plan. We were already engaged at the time, however decided to tie the knot earlier (on 9/28) in order to put her on my plan this way she can use my HSA benefits. Additionally, she enrolled into a lower deductible plan in September (before we were legally married), that was effective on 10/1. We are now paying a total of roughly 700 dollars per month in insurance premiums (between our two plans). My question is, would it be legal to drop her plan shortly after her surgery (which is on November 12th) since our marriage is considered a qualifying event and falls within the 60 day period from the time we were married? We would prefer not to pay two high monthly premiums.
 
Last edited:


quincy

Senior Member
Your question has nothing to do with medical and health care malpractice.

When were you married? September 28? Is she on your policy already?
 

quincy

Senior Member
Also, I misread malpractice for market place. My apologies
That's okay. It is actually not that uncommon an error.

And thanks for answering my questions.

You might want to wait for the forum member named "cbg" to post (she is employed in benefits) but, because marriage is a qualifying event, you should be able to drop your wife's policy once she is covered by your policy.
 

Smd09

Member
That's okay. It is actually not that uncommon an error.

And thanks for answering my questions.

You might want to wait for the forum member named "cbg" to post (she is employed in benefits) but, because marriage is a qualifying event, you should be able to drop your wife's policy once she is covered by your policy.
Ok, great. Thank you!
 

quincy

Senior Member
Ok, great. Thank you!
You're welcome. I appreciate the thanks.

I sent a message to cbg. You can look for her response, which should be more detailed than mine.

Congratulations on your marriage and good luck to your wife on her surgery.
 

FlyingRon

Senior Member
She can't contribute to an HSA if she has any coverage whatsoever that is not a high deductible health plan. I'm not sure that there is any restriction on retrieving money already contributed provided it is for an approved medical expense.

If you are within the qualifying life event window you can certanily change coverages subject to other plan restrictions.
 

cbg

I'm a Northern Girl
There is a difference between a qualified life event and an open enrollment period. During an open enrollment period you can make any change that is allowed by the plan. On a qualified life event you can only make certain changes that are directly related to the event itself. Marriage is not a qualified life event to drop dependents. Only to add them or, if necessary, to change their tax status from non-qualified to qualified.

Additionally, even if you work for one of the few employers who still have a 60 day window and not a 30 day (I understand there are still a few around) all changes have to be effective the date of the qualified event. If your Benefits office is willing you might be able to rescind the enrollment back to September 28th, as if it had never been, but in that case your insurance would not cover her surgery. You cannot pick an arbitrary date in November, even if it is still within the enrollment window, and cancel coverage as of that date. It's as of the date of the life event or not at all

If her plan is not a high deductible plan, she cannot use your HSA period.
 

Smd09

Member
There is a difference between a qualified life event and an open enrollment period. During an open enrollment period you can make any change that is allowed by the plan. On a qualified life event you can only make certain changes that are directly related to the event itself. Marriage is not a qualified life event to drop dependents. Only to add them or, if necessary, to change their tax status from non-qualified to qualified.

Additionally, even if you work for one of the few employers who still have a 60 day window and not a 30 day (I understand there are still a few around) all changes have to be effective the date of the qualified event. If your Benefits office is willing you might be able to rescind the enrollment back to September 28th, as if it had never been, but in that case your insurance would not cover her surgery. You cannot pick an arbitrary date in November, even if it is still within the enrollment window, and cancel coverage as of that date. It's as of the date of the life event or not at all

If her plan is not a high deductible plan, she cannot use your HSA period.
So as long as she has her plan, she will not be able to utilize my HSA benefits period?
 

cbg

I'm a Northern Girl
If her plan is a high deductible plan, she can. If she has any other kind of a plan, she cannot.
 

Smd09

Member
If her plan is a high deductible plan, she can. If she has any other kind of a plan, she cannot.
My open enrollment period is this month. Although I just added her to my plan, am I still eligible to drop her as it’s within the enrollment period?
 

cbg

I'm a Northern Girl
If you are asking whether or not you can rescind the enrollment altogether since it is still part of the initial enrollment period, that's a question only your HR or Benefits office can answer. The law allows them to permit it; it does not require them to permit it. It will be up to them and their policies whether or not you can do that.

If you are asking whether or not you can drop her as part of your Open Enrollment period so that she is covered through to the end of the plan year but then comes off when the new plan year starts, yes, you can do that.

What you cannot do is choose an arbitrary date after her surgery, even if it is still within the initial enrollment period, and drop her then. You can (if your Benefits office will permit it) cancel it altogether or you can do it during Open Enrollment as of the end of the plan year. The law is set up expressly to prevent people from doing what you're trying to do; have her covered only for the period of time she needs it and then dropping it so you don't have to pay premiums.
 
Sponsored Ad

Top