Kicked out of health insurance?

Question

Ive been in my job for over a year, and ever since i signed up for the company health plan, paying some 60 bucks/month. My health has been crappy lately and Ive been having weekly counseling therapies, lots of specialist appointments, necessary and expensive heart, neurological and other exams, a root canal, 2 emergency hospital visits (one requiring a 2 night stay and the other a 4 night stay), chirpractor visits, medicines, etc. Im starting to get worried that either I could get fired or that insurance would suspend my coverage.

My question is: Do companies have to pay something like a deductible or higher rates for their employees' health insurance every time they get medical attention? Can insurances kick you out if you are "high demand"?

Thanks

Answer 1

Hello there,

Sorry to hear that you've had one of those years where it seems like you're going to the doctor every 15 seconds.  I've had those years too.

What will happen is that your company will go through an open enrollment period when their plans will be reviewed by the company, and claims experience will be reviewed as criteria.  

You can not be kicked out of your health plan from a group insurance plan just because you're a high utilizer.  Group insurance policies offers that protection.  Now, the rates will most likely be going up because of claims utilization, but you can't lose your coverage unless EVERYONE in the company loses it.

I wish you better health in the coming years.

Good luck!

Kathy K

www.premiumwatchdog.com

Answer 2

No, it's not like car insurance.  Once you're on, you're on, and they can't "surcharge" you for claims that you put in.  

Answer 3

Your group health insurance is guaranteed issue, and neither the insurance company, nor your employer can kick you off the policy.  See link below for text of the law.  

Your employer may,or may not have to pay a higher rate next year due to your claims. It depends on lots of factors like: large group VS small group, partially self funded, community rated, the open market, state laws, etc... Your employer is already paying big bucks to the insurance company, just so you have coverage for health issues like these. I doubt your claims are anything unusual to the insurance company.

As to getting fired I have no legal advise. I would recommend keeping your employer informed and doing your job as best you can.

Good luck.

Don

http://mtnhealthinsurance.com  

Answer 4

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