Health Insurance Question: New Born and Change of Insurance

[Ann H]

It depends on whether or not your employer did the "deductible funding" portion correctly through an HRA (Health Reimbursement Arrangement), and whether or not they have professional administration of that benefit. If they have an HRA, with a plan document, and that HRA is professionally managed, then the payment should go through without a hitch. If there is no HRA plan document and your employer is just doing this informally, that's another issue.

What IndividualHealthGuy was trying to explain in his prior post, is that you can continue HRA benefits under COBRA. Following is a link to an IRS document that explains that you can keep the HRA benefits under COBRA - http://www.irs.gov/pub/irs-drop/n-02-45.pdf. To make it easier, let me quote part of it that answers this question for you:

An HRA is a group health plan generally subject to the COBRA continuation coverage requirements. If an individual elects COBRA continuation coverage, an HRA complies with these COBRA requirements by providing for the continuation of the maximum reimbursement amount for an individual at the time of the COBRA qualifying event and by increasing that maximum amount at the same time and by the same increment that it is increased for similarly situated non-COBRA beneficiaries (and by decreasing it for claims reimbursed).​

 

[murugappanp]

It depends on whether or not your employer did the "deductible funding" portion correctly through an HRA (Health Reimbursement Arrangement), and whether or not they have professional administration of that benefit. If they have an HRA, with a plan document, and that HRA is professionally managed, then the payment should go through without a hitch. If there is no HRA plan document and your employer is just doing this informally, that's another issue.



What IndividualHealthGuy was trying to explain in his prior post, is that you can continue HRA benefits under COBRA. Following is a link to an IRS document that explains that you can keep the HRA benefits under COBRA - To make it easier, let me quote part of it that answers this question for you:

An HRA is a group health plan generally subject to the COBRA continuation coverage requirements. If an individual elects COBRA continuation coverage, an HRA complies with these COBRA requirements by providing for the continuation of the maximum reimbursement amount for an individual at the time of the COBRA qualifying event and by increasing that maximum amount at the same time and by the same increment that it is increased for similarly situated non-COBRA beneficiaries (and by decreasing it for claims reimbursed).​

Hello Ann

Thanks for the explanation. You really made my day better. I never understood that why my company pays the dedutible. Thanks for your explanation on HRA and I learnt something today. I know that my company does something with HRA as they mention in benefit documents and they have a very big company as their administrator.

So now I understand that when COBRA is used, everything remains same as per coverage and dedutibles are concerned. The only thing is I will pay the premium fully.

 

[Ann H]

Hello Ann

So now I understand that when COBRA is used, everything remains same as per coverage and dedutibles are concerned. The only thing is I will pay the premium fully.

You are correct about this, and I'm glad your company has a formal HRA with a large administrator. Remember, you can call the administrator directly with any questions.

 

[murugappanp]

You are correct about this, and I'm glad your company has a formal HRA with a large administrator. Remember, you can call the administrator directly with any questions.

I am hesitant to call the administrator and ask questions about COBRA/HRA because they might tell the company on my intentions of moving to another organization. I was always calling the insurance company but they dont have much info to share. They keep on telling that my deductible is $5000