Change of insurance company?

Question

I just found out yesterday that the company I work for is changing insurance providers July 1st of this year. The thing is I'm in the 8th month of my pregnancy right. I'm on Highmark Blue Cross Blue Shield and they cover all doctor's appts plus the delivery and all I would have had to pay is the $250.00 deductible at the end. However my due date is July 10th, so I'm not sure how this is going to work. I called my doctor's office to see if they knew but the person in charge of billing won't be in until Monday. I think I'm gonna have to pay the highmark bill (all doctor's appts. up to June 31st) and then the UPMC health plan bill (which is probably going to be one or two visits and then the delivery). I just have no idea what the deductible is or whether the hospital I'm delivering at is covered under the new insurance. Is there anyway I can find out how much its gonna be before I deliver?

Answer 1

Check with your HR dept. Usually, since you are so close to delivering, the new carrier will pay your doctor and hospital as preferred (if they are not) and if you are into 100% coverage, will waive any co-ins or deductibles FOR YOUR OB CARE AND HOSPITAL ONLY.

Answer 2

Yes, go talk to your HR department, ask them to talk to the sales guy for the new insurance company, and ask them how it's set up, coordinating the new plan with the old plan.

Worst case scenario . . you can always ask your doctor to induce you on June 30th.

Answer 3

Typically, when a company abandons one health care plan for another, they have to give you access to a comparable plan, if not allow you to continue the one you currently have - you assuming the cost of the full plan.  Most employees have no idea how much their company pays for the coverage, and many have a hard time swallowing the reality that comes along with the sticker shock.

The best place to start getting answers is by stopping-in and talking with those in your HR Department to get a clear understanding of the other options that you have.  Some can choose to have a portion of the benefit costs in the form of cash ILO the new benefit.  Cafeteria Plan Administration can be found on the IRS website.  You can also ask for a copy of the current cafeteria plan administrative guidelines (POP Plan Docs) for your company while visiting your HR team.  The Plan Summary must be provided to you, and every other participant, by law.  If your employer pays 100% of the benefits cost(s), then a plan doc might not exist.

The new carrier must assume the current status of the group regardless of claims history.  Regarding your pregnancy, some states make you wait 10 months before certain disability benefits come on-line, so be sure to press this point with your HR Dept. until you are satisfied that the answer is favorable to you.  If you do have a Short-term Disability policy, then you might have a number of weeks in which you qualify for a portion of your salary to be paid while on leave.  Best of luck!

Answer 4

call the new insurance company NOW and ask about "Continuity of Care".... most times, you will be able to set it up where the old carrier will pick up the rest of the bill because you are so close to delivering... i work for blue shield, and this is how it works....

additionally, you should try to enroll into an HMO if available, to ensure that your out of pocket is as low as possible. the only problem, is because you are so far along, the HMO might push back because they don't want to incur that cost.

if i were you i would ask as many questions possible about this new carrier and new plan.

Answer 5

Find out who the new company is going to be and ask to talk to a rep from that company.

Answer 6

Contact the person in HR who is handling it all. They should be able to get the answers you need.