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  1. #1
    Join Date
    Aug 2007
    Posts
    2

    Default Notification When Benefits Change

    My wife and I just found her that her company (fortune 500) changed the employee health care plan in December 2006. We're expecting our first child at the end of September (you can see where this is going....). Her health insurance now requires her to pay 10% of all hospital expenses - which for a natural birth could be $1000 - $1,500 - plus the deductible of $300.

    She was shocked when she learned this and asked several coworkers and none of them knew about the change (her company is 90% female, so this would be something many would/should be aware of).

    She asked her benefits person about it and was told it was discussed at an open employee meeting last December. My wife - and her coworkers - remember an e-mail that discussed attending the meeting if you wanted to change your coverage, and the only mention of the change to existing coverage was an increase in the deductible - not a reduction in coverage. She is attempting to get a copy of the original notification e-mail to see if she and her coworkers are correct in how the meeting was described.

    I should mention that this is in Pennsylvania.

    My question is - how thorough must employers be when changing existing coverage? Is saying "an increase in your deductible" the same as what they meant - "an increase in your deductible and a reduction in your overall care"? Obviously, we were actively trying to get pregnant at the time this happened and we both strongly believe that if a notification mentioned an changed to existing coverage (other than just an increased deductible) she would have attended the meeting.

    Thank you.

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

    Default Re: notification when benefits change

    A question - and yes, it makes a difference:

    Are the benefits with the same carrier as before? Or did the carrier change?

  3. #3
    Join Date
    Aug 2007
    Posts
    2

    Default Re: notification when benefits change

    Same carrier (Aetna)

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

    Default Re: Notification When Benefits Change

    If the benefits had gone to a new carrier, there would have been forms that had to be signed. If you had said it was a new carrier, there would have been red flags all over the place.

    Since the coverage stayed with the same carrier, it's just a roll over. So now I have another question for you. Outside of going to a meeting, if she had known about the changes, what would she have done?

  5. #5
    Join Date
    Sep 2007
    Posts
    23

    Default Re: Notification When Benefits Change

    Unfortunately your insurance increase in co-pays qualify as an increase in deductable for health insurance purposes.

    Your employers notice of change in coverage and invitation to a meeting was designed to cover thier butts in just such an event as yours.

    It does cover thier actions.

    Sorry

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