time limit when adding spouse (recently married)

[Thumbelina58]

I was married on Feb. 12, 2002. When I tried to add my new wife to my health insurance policy on April 2, I was told I had waited too long because "federal law" required that I add her within 31 days from the date of our marriage. My insurancve provider says I have to wait until Jan 2003 to add her, and that this is not THEIR policy, but a law they must abide by. Is this correct? Are there any exceptions?? THanks

 

[cbg]

If the insurance policy is under a Section 125 and has a January 1 renewal date, yes, that would be correct.

Do you pay a portion of the premiums and if so, are they deducted from your paycheck pre-tax or post-tax? The answers will determine if this is a 125 plan.

Mind you, even if it is not, most plans do require that spouses be added within 30 days and if that window is missed, not until the plan renewal, so even if it's not a 125 plan, it's entirely possible that what they're saying is correct and legal. The only difference would be whether it is Federal law or contractual.

 

[Thumbelina58]

Hi, and thanx for your reply. Yes, I do pay the premiums from my paycheck, and it's deducted before the taxes come out. They said it was not THEIR policy, but the "law". So I guess you're saying she has to wait a year before she's covered then , right?

How would I know if it was federal law or contractual and would that have any different effect?

 

[cbg]

If there are premium payments coming out of your paycheck on a pretax basis, then you are on a Section 125 plan and it's Federal law. You will have to wait for the next open enrollment period, which from what you are saying is January 2003. There can be no exceptions.

If there were no premium payments coming out of your paycheck, or if there were but they were post tax, it would be contractual. The ONLY difference would be if it were contractual, if BOTH your employer AND the insurance carrier agreed to it, they could make an exception if they chose to, but they could not be legally compelled to. Since it is Federal law, they cannot make an exception even if they wanted to.