Comments on: They’re ineligible for your health plan, but you’re still paying

By: The Top Ten HRBenefits Stories of 2009 | HR Morning | Your daily dose of HR

Wed, 06 Jan 2010 15:34:38 +0000

[...] They’re ineligible for your health plan, but you’re still paying [...]

By: Lorrie P

Lorrie P — Wed, 22 Jul 2009 00:35:37 +0000

Response to Judy: We are a self insured employer for our medical and we offer NO coverage for an ex-spouse. When I checked with our HR Consultants they informed me that if we would receive such a support order we can refuse to provide due to our policy. What happens then is the employee/spouse, if court ordered, has to find his/her own policy to cover the ex-spouse to fulfil the court order. I’d check into it further. Hope this helps.

By: al gilmour

al gilmour — Tue, 21 Jul 2009 15:38:06 +0000

HEY JUDY WHAT STATE IS YOUR BUSINESS? ALSO WHAT DOES YOUR GROUP POLICY READ FROM UNDERWRITER REGARDING DIVORCE ETC. ALSO IF JUDGE ORDERED EMPLOYEE TO KEEP SPOUSE ON HEALTHCARE PLAN THAT DOES NOT PREVENT YOU FROM CHARGING SPOUSE RATHER THAN COMPANY PAYING. THE JUDGE IS JUST INTERESTED IN HAVING MEDICAL COVERAGE NOT WHO IS PAYING FOR IT ETC. IT MAY SOUND CRUEL AND UNFAIR TO EMPLOYEE TO PAY HOWEVER BUSINESS MUST DRAW A LINE BETWEEN PERSONAL PROBLEMS VS RUNNING UP MEDICAL PREMIUMS ON SOMETHING THEY HAVE NO CONTROL OF ETC.(I.E. LENGTHY DIVORCE SETTLEMENT) I AM IN CALIFORNIA AND CAN GET AWAY WITH HAVING EMPLOYEE PAY PREMIUM. MAYBE YOU CAN SPLIT COST OF PREMIUM TO EASE PAIN FOR EMPLOYEE. HOPE THIS HELPS.

By: Judy

Judy — Tue, 21 Jul 2009 13:21:28 +0000

Does anyone have a policy that you are willing to share regarding court-ordered covered benefits for spouses during divorce proceedings? Last year the judge ordered our employee to keep her spouse on her healthcare plan until the divorce was final. It was a bitter divorce, and took more than a year. We are a small company under 100. We were the losers, as we pay 100% of the premium and deductible.

By: Lorrie P

Lorrie P — Thu, 16 Jul 2009 19:28:26 +0000

I’m with Al, I work for a smaller company of about 160, but with 3 locations. Since we fired our TPA about 4 years ago, I have gone through each benefit billing statement with a fine tooth comb and now have every confidence that all members have the correct coverage. I monitor this every month. Working with a smaller company also gives me the opportunity to converse and communicate with all the employees and allows for an excellent relationship. I typically know of most changes in status with them.

By: Mar

Mar — Thu, 16 Jul 2009 18:58:41 +0000

One advantage to having a Benefits Analyst (employee of the HR dept). She knows EVERY employee, EVERY dependant, and she is on top of every move. I am confident that we do not pay one dime that is not legitimate. You can’t get that with a TPA! (we have 1100+ benefit-eligible employees)

By: asiral

asiral — Thu, 16 Jul 2009 17:12:04 +0000

I have 162 employees to keep track of. To make it easier I keep a spreadspread where I highlight in red someone who termed, switch to pt or cancells the insurance and once the change has been done by the insurance company and then I highlight in blue. Once I get the new invoice I delete the person from the invoice. I copy each month so if there is a problem I can always go back to see what I did and what month the change happened. it is pretty easy to keep track of it this way.

By: al gilmour

al gilmour — Thu, 16 Jul 2009 16:37:33 +0000

One of the advantages in having a small company. This kind of negligence seldom happens. Each time a billing comes from Group Carrier we go over it in detail before paying. Also with 20 employees in each division (which calculates to about 45 dependents on the average per billing) it is easy to know who is who etc.