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  1. #1
    Join Date
    Apr 2018
    Location
    Columbus, Ohio
    Posts
    2

    Default Lapse in Health Insurance Coverage Resulting from Marriage

    My question involves labor and employment law for the state of: Ohio

    My Wife and I were married less than 30 days ago and we are moving her to my insurance as the coverage is significantly better than what her work offers. The issue is that for my employer the coverage will not go into effect until 05/01/2018 while her HR department is telling her that her coverage will drop retroactive to the day of the wedding. Are they legally allowed to do this or does she have the option to maintain coverage until 04/30/2018? If the coverage is dropped retroactive and she had a dental checkup 04/16/2018 are we now required to cover the cost that otherwise would have been covered?

  2. #2
    Join Date
    Jun 2006
    Location
    Massachusetts
    Posts
    24,521

    Default Re: Just Married - Wifes Employer Dropping Coverage Retroactive to Day of the Wedding

    They are not only legally allowed to do that, they may in fact be legally required to do that. If you are making a change based on the marriage, they are almost certainly required to do it as of the date of the marriage. IRS law strictly regulates when and under what circumstances an employee is able to make changes; if her employer's plan document states that off-cycle changes such as marriage are effective as of the actual date of the event (which is not only legal, but is in fact preferred) then there is no legal option of doing it on any other date.

    You might try to see if they will amend the change to be based on "gaining other coverage" instead of marriage. You will need to bring in something from your employer, signed on letterhead, that names her by name and confirms that her coverage begins on May 1. It's by no means a guarantee but it's worth a try.

  3. #3
    Join Date
    Apr 2018
    Location
    Columbus, Ohio
    Posts
    2

    Default Re: Just Married - Wifes Employer Dropping Coverage Retroactive to Day of the Wedding

    Follow up question, if she paid insurance premiums for the entire month is she entitled to a prorated refund as she only ended up receiving a week of coverage?

  4. #4
    Join Date
    Jun 2006
    Location
    Massachusetts
    Posts
    24,521

    Default Re: Just Married - Wifes Employer Dropping Coverage Retroactive to Day of the Wedding

    That depends on her employer's policies.

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