<p>Since I have gleaned so many useful tidbits from this site over the last few years, I thought this would be a perfect place to bring this question. My recently graduated, 22 year old son has secured employment beginning in July. Today, he was completing the pre-employment forms online and came to the page where he needed to select his health coverage. The company offers group Anthem Blue Cross coverage for a cost of $30 per month for self only. But, if he waives the coverage, the company will increase his taxable pay by $1800. </p>
<p>He is currently covered on my H’s Blue Cross plan through the federal government and, according to their literature, S is covered until age 26, no matter what. He can be financially independent and, even if his employer offers coverage, he is still covered under H’s plan. Of course, if S does sign up for his employer’s coverage, H’s plan becomes secondary. </p>
<p>What is the downside to S waiving his employer’s coverage? Is there one? I feel like I am missing something. I know that as he approaches age 26 he will have to make sure to catch the next open enrollment period to get on the employer’s plan before his 26th birthday. </p>
<p>Of course, S sees dollar signs and wants to waive the coverage. I just don’t want him to make a decision that he could later regret.</p>
<p>I’d just have him ask them what hoops he has to jump through to get himself added onto the employer plan in the future. Company is increasing his pay because they aren’t having to pay for his insurance so it could be a win-win for both. That being said, if he’s not a healthy person it may be nice to have the two plans. Just depends on the situation.</p>
<p>Your son could go on his own company’s plan when it was not “open enrollment” if he had a “qualifying event”. (i.e. like your husband lost his job & did not want to make COBRA payments to keep his family members on the plan). </p>
<p>Many plans don’t offer “couple coverage”, a couple is a family plan so employee pays same amount of premium for two people vs. say, five people. We had one child just go off plan as she turned 26, but now has her own coverage. Another child who is 24 is still on the plan. Still same premium of course as we are on a family plan.</p>
<p>fendergirl, S is in good health so that isn’t a factor at this time. We have told him he needs to double check with the employer to find out how to enroll in their plan when the time comes.</p>
<p>Mafool, H doesn’t pay any more to cover our S & D up to age 26, than he will when he is just covering himself & I. His only choices are Self or Self & Family. So, covering our S doesn’t add to our costs. </p>
<p>As a federal retiree, H’s coverage should be secure, but given today’s economic climate, my mantra has become ‘never say never’. If the terms of H’s coverage were to change, I do feel confident that there would be an adequate period of time provided for making alternative arrangements.</p>
<p>SLUMOM, our family coverage sounds like it works like yours.</p>
<p>I have personal experience with this. DW had better insurance coverage at her place of work. Choices were ‘Single Insured’ or ‘Family Insured.’ At my company choices were ‘Single,’ ‘Family’ or ‘Opt Out.’ I took the ‘Opt Out’ and it worked out great for our family. </p>
<p>As fendergirl pointed out, a lot depends on each individual’s situation. If S is healthy (you say that he is) and H’s insurance coverage is competitive with that being offered to S, then ‘Opt Out’ may work for your family.</p>
<p>Just be sure to check if he CAN stay on your plan. It’s my understanding that he is NOT covered until age 26, no matter what. If a child under the age of 26 is eligible for a plan at his place of employment he CANNOT stay on his parents’ plan. The opportunity for children up to the age of 26 to remain on their families plans was designed so that they would not be without coverage.</p>
<p>Make sure you get the correct information so that he does not end up without coverage. You don’t want to find out when they won’t pay for services.</p>
<p>gus, I had originally thought the same, but here are two quotes regarding children’s eligibility to remain on the plan until age 26 from H’s plan’s website:</p>
<p>“All married and unmarried children between the ages of 22 and 26 are covered under their parent’s Self and Family enrollment up to age 26. They do not have to live with the enrolled parent, be financially dependent of the enrolled parent or be students to remain covered until the age of 26. A married child’s spouse and children are NOT eligible for coverage.” </p>
<p>and</p>
<p>“Children who are eligible for or have their own employer-provided health insurance are eligible for coverage under the enrolled parent’s coverage up to age 26.”</p>
<p>I think we are OK on that end. It’s making sure on the employer’s end that he will be able to switch in the first open enrollment period before he turns 26 that I need to check on.</p>
<p>One consideration, if your husband’s plan has in network and out of network providers (and different amounts of coverage/separate deductibles for each), is that if your son is in a different market, he may have to use only out of network providers. Is this a consideration?</p>
<p>Similarly, are there doctors/hospitals/other health providers who take your husband’s insurance where your son will be living?</p>
<p>Why on earth do you want your child on your plan? He’s got a job, he’s trying to be independent, let him get his own health insurance policy. I don’t care if it’s cheaper or more expensive, adults have their own policies.</p>
<p>Physician here. Whatever he does, make sure he has health insurance coverage. It is amazing what an appendectomy costs, or injury from a weekend sports mishap- even for a perfectly healthy person. The financial risk of going without coverage can be devastating. I understand wanting to save money. But there is also the independence of taking care of all of your needs.</p>
<p>Be sure to get what you found verified by someone for your specific situation.</p>
<p>I’d think the peace of mind for a maximum of $1800 to KNOW you have good insurance and actually both primary AND secondary coverage is worth much more than that, especially if some unexpected event occurs. Heck, that’s cheaper than we’re paying to insure 3 cars fora year!</p>
<p>For us, it would also be an issue to be SURE that the young adult can find participating & preferred providers & medical centers where he is now living, since it can make a huge difference in reimbursement. We had just assumed that S would sign up for his own coverage at his new place of work. I guess we’ll double-check to see if he can remain on H’s policy as secondary coverage, “just in case.”</p>
<p>Here is one scenario which could cause you problems if your son turns down coverage with his employer: He stays on your Husband’s plan, and between now and when he turns 26 he gets sick and your Husband loses his job. Your son will not have any coverage, will not be insurable because of pre-existing condition, and may have to wait before enrolling in his employer’s plan. If for some reason he is no longer working for this employer, he may have real difficulty finding insurance, except for maybe Cobra at very high rates.</p>
<p>Not at all true. By having continuous coverage, all pre-ex clauses are waived.</p>
<p>Employee benefits expert here.</p>
<p>When I counsel new hires, I tell the ones who are < age 26 to consider remaining on their parent’s plan. When they reach age 26 and are no longer eligible to remain on that plan, that consitutes a “life event” and they can come onto our plan. </p>
<p>If your husband loses his job, your child can also go onto his own employer’s coverage at that time. </p>
<p>There is no downside, and $1800 is a pretty darn good upside. If there is an incremental cost to keeping him on your husband’s plan, your child can pay it to you from that $1800.</p>
<p>I have to weigh in on the actuary’s side. As a nation we are extremely overinsured. The point of insurance is not to reduce your out-of-pocket expenses to 0. It’s to insure against unpredictable, high-cost events. If you’re absolutely certain your son can stay on your family policy, that’s what he should do. BC/BS through FEHBP is a great plan. He should then re-evaluate his/your situation during his company’s open season each year and decide if he wants to switch coverage.</p>
<p>What happens if son opts out of father’s plan and his (son’s) job status changes so that he is no longer eligible for this insurance (except through expensive COBRA)? Is it a quick fix to re-join the family plan without waiting for open enrollment? No insurance expert here, just curious.</p>
<p>Wow, thanks for all of the great replies! To address common issues that some of you have brought up:</p>
<ol>
<li><p>As a federal retiree, H’s coverage is permanent. I suppose there is an infinitesimal chance that the gov’t could renege on it’s commitments, but as VHappy states, if that happened, it would qualify as a ‘life event’ and S could move to his employer’s plan. </p></li>
<li><p>When comparing levels of coverage, the only area in which Anthem might be better than the FEP is on dental coverage. FEP only covers preventative services. To pay, in effect, an extra $2160 ($360 in premiums and $1800 in lost income) for possible better dental benefits does not seem to make much sense.</p></li>
<li><p>We’ve been searching the Anthem website for providers and can see that his current suburban doc would be in-network. He’ll be living in Chicago and it appears that all the major hospitals are also covered in-network. It seems that both plans cover pretty much the same providers. (I long for the days when there was a paper directory of providers. Comparing through the company search engines is exhausting!)</p></li>
<li><p>S can’t officially ‘opt out’ of H’s plan. He could choose not to use it as secondary coverage, but I don’t know why he’d want to do that. If S were to lose his job, he would still be covered under H’s plan until age 26.</p></li>
</ol>
<p>VeryHappy and MyLB, thanks for confirming how the system works.</p>
<p>dmd, it’s not that I WANT S on our plan. He IS on it until age 26 according to the terms of H’s coverage. Initially, both H & I had a negative reaction to S waiving his employer’s coverage. But S’s argument is: Why pay $30/month and lose $1800/year to have what amounts to duplicate coverage?</p>
<p>And thanks again to all who have responded. This discussion has really helped us crystallize the issue.</p>