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View Full Version : Health Insurance! AAAAAAHHHHGGGHH!



Marisa6826
05-29-2003, 08:26 PM
We were getting our health insurance through my last job. My boss was kind enough to let us continue to get coverage even while I was out on extended leave due to complications during my pregnancy with Sophie.

Well, we agreed that I would go out on COBRA as of June 1st (I've been paying the full cost of almost $800/mo all the while I've been out).

This afternoon he called me to say that Aetna doesn't provide COBRA insurance if the employer's company has less than 25 employees.

Jonathan's been working freelance on and off for the last three and a half years (he's in the internet advertising field) so no benefits! I looked into freelancer co-ops a little bit and they are with companies I've never heard of. I can't STAND the thought of hunting for new doctors all over again.

What the hell are we going to do now? My boss said the he would cover me till the end of the year. But after that, we are on our own.

New Jersey only has two insurance companies (Horizon BC/BC and Oxford) that offer individual family plans and they are well over $1000/mo. The ones I saw online were $1200+

Just when you thought you were handling things just fine. BLAM!

-m

sntm
05-30-2003, 12:01 AM
that's almost criminal! no advice, but i'll be wishing you the best of luck in finding something. even the $800 seems unfair!

shannon
not-even-pregnant-yet-overachiever
trying-to-conceive :)
PREGNANT! EDD 6/9/03

zen_bliss
05-30-2003, 03:18 AM
it's great that your boss will let you continue to purchase your insurance as part of his group through the end of the year. that gives you some more time to research.

but that doesn't sound right. call aetna yourself just to be sure. my understanding is that COBRA is a governmental mandate. this got me so steamed i did some looking around.

according to this, in NJ there IS cobra for businesses with 2-50 employees but now the employer has to collect the payment rather than the person being billed directly.
http://www.aetna.com/employer/sb_admin_policy.html
http://www.aetna.com/producer/midatlantic_smallgroup.html

in my aetna book:
"COBRA applies to employers with twenty (20) or more eligible employees... This refers to number of employees employed, not the nubmer of emplyees covered by a health plan, and inlcudes full-time and part-time employees."

"The California state law is the California COntinuation Benefits Replacement Act ("Cal-COBRA"). Cal-COBRA applies to Califonrina small employers with fewer than twenty (20) eligible employees. Many of the provisions of COBRA and CAl-COBRA are the same, however some differnces do exist."

(frogive typos, squirmy baby)

point is, your state almost certainly has got to have some kind of set up for small businesses...it's just inhuman... i hope this was just a mistake and that there is some good news for you!

hope this helps. we are all pulling for you! dealing with insurance is incredibly stressful.

himom
05-30-2003, 06:01 AM
I can sympathize. My DH works for a small company with only three employees, and health insurance for me and DS would have been $800+ a month under his plan!

Iím not sure if this would work for you, but Iíve solved the insurance problem by taking on a part-time job that provides family insurance. To be honest, I HATE it. (Itís retail, I hate being away from the baby, and I feel stupid running a cash register when I have an education and much more potentialÖ.)

But it works. I work three nights a week at a brain dead job that requires very little attention from me, DH watches DS so heís not left with strangers, and we have health insurance.

Itís okay, though. Iíd sacrifice a lot more for my baby, but it does hurt to see career opportunities zoom by while I am forced to spend my evenings asking customers if they have noticed that our frames are currently 25% off. :(

Jodi
Mommy to Joshua Keoni, 2/8/03

lukkykatt
05-30-2003, 08:41 AM
My friend is in a similar situation, and I found some good information for her on this site: http://covertheuninsuredweek.org/

It has links to some pretty informative sites. Hope you find something there that may be of some use!

Marisa6826
05-30-2003, 09:40 AM
Zen-

Thanks so very much for looking into this. I thought the same thing was true about the COBRA being legally required.

I called back my former employer (see **I** was the one the used to deal with the insurance there, and being that I can't legally make the phone calls anymore it's really annoying) - the girl that replaced me is new and doesn't know how to make the rounds to get the right info.

She called the BROKER not AETNA. The Broker is not only a bitch, she's an idiot. I'm having her call Aetna today to verify what I thought to be accurate - I'm eligible, but my EMPLOYER has to receive the monthly payment (and then send it to Aenta).

My employer only has two people on his books - long story - so it's cutting it close.

What really sucks is that although Jonathan is technically not an employee of the company he works for, he gets a W2. Essentially, he works full time without any benefits. It is unfair, but in this economy (especially in the internet field), we are willing to take whatever work he can get. He is going to speak to the HR person about any possibility of him getting a permanent job with him. Sure the money will decrease exponentially (kickass day rate right now), but we would get benefits.

I've been in a complete rant over this for the past 12 hours.

It's nice that the President can authorize billions of dollars of tax cuts, but so many people don't have basic health insurance for their families....but that's a whole OTHER bitching rant!!!

Thanks again

-m

Marisa6826
05-30-2003, 09:44 AM
Jodi-

That really sucks. I actually offered to come back to my former employer a couple days a week. I would bite the bullet, get a babysitter for Sophie and just go. He basically said, thanks, but no thanks. He's already hired a replacement fulltime.

Jonathan generally doesn't get home from work till 7:30-8pm so I couldn't easily get a job. Also, most PT jobs don't offer benefits.

One of the main reasons I stopped working was that babysitters here where I live run about $15 hour and it just didn't add up for me to go back.

I'm sure I will figure out a solution. There are ALWAYS solutions. Sometimes we just don't like them!

-m

Marisa6826
05-30-2003, 05:53 PM
Well. There was another conversation with Aetna and I'm definitely NOT eligible for COBRA. New Jersey doesn't mandate it.

How much does THAT suck?!

I have a call into my FIL to see if he has any ideas. He used to be the Superintendant of Insurance for NY State. Was hoping to keep him out of it, but looks like I don't have a choice.

ARGH!

-m

MamaRox
05-31-2003, 05:13 AM
Marisa:

It's too bad we don't live in the same state....we could definately do lunch and comiserate together!!!

My husband was laid off in July, so it's almost been a year. At the time I was 4 months pregnant. Lucky for us, his boss is rich and kind and offered to continue our insurance coverage out of his pocket so we weren't screwed with the pregnancy. It was very expensive, $850 per month, as it was a small company policy. Then, after our baby was born, we were supposed to take over the payments. It was gonna suck big time, but COBRA was just as expensive, so we were gonna try to do it.

During this time, my husband (who happens to be in the Multimedia/Internet industry also) was working for his old boss as contract labor (self-employed). So the boss came to him and said, since business was good, he'd continue to pay the ins. premium. So that was a HUGE relief.

Then, one day out of the blue, March 24th....he gives us barely a weeks notice that he would not be making the payment due on the last day of March. So, needless to say, we were unprepared to make the payment with so little notice, while still trying to pay off some complicated hospital bills from the baby.

So, here we are 2 months later and this causes huge stress for me and DH. We still haven't found an affordable insurance plan. They all run over $900 a month for all 5 of us, without maternity benefits. (We have no plan for any more kids, but it never hurts to be prepared, baby #3 wasn't exactly planned.)

So....we are screwed, too.

I feel for you, honey, we are living the same nightmare!!!!!!

Marisa6826
05-31-2003, 01:23 PM
Roxann where are you located?

-m

MamaRox
05-31-2003, 07:28 PM
I live in Oklahoma....it's bad all over.

Roxann

Marisa6826
05-31-2003, 09:18 PM
Have you looked into freelancer organizations for insurance co-ops?

http://benefits.nase.org/show_benefit.asp?benefit=endorsed

I had never heard of this insurance company, but maybe since you're in OK, you may have.

Good luck.

-m

MamaRox
06-01-2003, 01:55 AM
Hi Marisa:

Thanks for the idea. We had heard of it. When my husbands company was reduced to only 3 last year before he was laid off, they almost had an insurance plan with NASE, but didn't go with it because the plan wasn't very good and it was going to be very expensive. I don't know if it has changed, though. I hadn't even thought to check again, since it's been over a year.

Did you find anything thru NASE that you could use?

Marisa6826
06-01-2003, 01:37 PM
Nope. They only have that one insurance company and I had never heard of it. Don't really want a no-name company when it comes to insurance!

-m

mama2be
06-01-2003, 01:53 PM
Yikes those numbers seem so high. My hubby was looking at going with BC BS of NC and we were looking at about $450 a month to cover all 3 of us Now I am wondering if he did his math wrong or something.

Do you have military connections or are you even a dependant of a previous military person (your dad) or you DHs dad...becaseu USAA offers helath insurance soemthing we are thinking af looking into ourselves if my hubby becomes a contractor...

Keep us posted and good luck...these situations break my heart and don't you know they are everywhere!!!

Marisa6826
06-01-2003, 11:18 PM
Neve-

My brother was USCG. He just left a year ago. Does that count???

Incidently, you have the MOST handsome husband and son!!

-m

gravymommy3
06-02-2003, 09:03 AM
Couple of thoughts here -

Does you state have an insurance program for kids? Here in GA, they have Peachkids and it provides insurance for kids of parents with low to middle income (I think - don't exactly know what the income levels are for eligibility.) The other thought - our neighbors purchase their own insurance - they bought individual policies which is cheaper and better if one kid has a medical prob. Worth looking into.

MamaRox
06-02-2003, 10:28 AM
Neve:

Is this insurance available to me if both my parents were in the US Air Force 35 years ago. My mother has passed away, but my dad is alive and lives near me. So, he would be my kids grandpa, of course. I didn't even know this was an option.

And about BC BS, in Oklahoma we looked into this. It is somewhat affordable, but my friends applied for it and it took over 4 1/2 months to get it approved and started and the application process was insane. They wanted EVERY doc. appt. for the past 3 years for all 5 of them in her family and details of what the appts. were for. Then, when they got the details, they wouldn't cover anything that was in those appts for the past 3 years. So, although the coverage was less expensive than most, it was almost more like major medical because they excluded EVERYTHING.....So that's why we didn't go with them and we are still looking.

Looking forward to hearing about the govt. ins.

Thanks for the idea

MamaRox
06-02-2003, 10:31 AM
They do have state insurance in OK for children, but we are ineligible because my hubby makes too much, just over there guidelines. Doesn't that stink? Nobody factors in how much debt we are carrying since we haven't had a job for 1 year now. After you pay all bill and cc pmts., there isn't much left. And certainly not $900 for insurance.

Thanks for advice

gravymommy3
06-02-2003, 02:42 PM
I don't think that my neighbors pay that nuch for their insurance. The older child has CP and gets some state assistance, but they have a policy for him for stuff that is not coverec. The mom said a family policy was a lot more expensive than separate ones.

jenmcadams
06-02-2003, 05:30 PM
Roxann -

Neve might be able to betetr answer this, but my dad was USAF and I qualify for USAA for home owner's insurance and car insurance. It is a great company and we have always found that the rates are competitive and the service is better than any other insurance company we've worked with. I'm not familar with their health plans, but my guess is that you'd qualify given both parents were military.

website is www.usaa.com

Jen

Raidra
06-06-2003, 03:52 PM
Have you called any local hospitals for help? I work for a hospital in Massachusetts and we have a financial counseling office. They have tons of info not only on things like Medicaid, but several different low cost insurances, some that cover families and some that cover just children. There is also something called Free Care in Massachusetts where, through either medical or financial hardship, all medical expenses at a hospital can be covered. I'm not sure if that's something that all states have.

Anyway, I'd try calling a local hospital (non-profit would be better than a private hospital) and asking for a financial counseling office. It's in a hospital's best interest to get everyone insured one way or another, so they usually have GREAT info on what's available.