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Didn't realize till now there's a Health Insurance forum here - the perfect place for me to ask this question!
Why do insurance plan deductibles go by Calendar Year instead of Plan Year? For instance, if an employer typically has it's enrollment period (the time when they might typically change health plans) mid year, why would your deductible "reset" January 1st? You're missing out on MONTHS in which you could meet your deductible.
I'm in this situation now. I have pretty crappy health insurance through an employer. I became eligible for coverage in May 2015, which is also when they switched to a new health plan. So EVERYONE became eligible in May 2015. The plan is the kind where you have to meet the whole deductible before you get almost any benefits. We've just met the Family deductible a few days ago, so benefits finally kick in but only until the end of the month!
Or are the premiums "supposedly" reduced based on that starting date?
Not all employer insurance plan deductibles go by calendar year. Yours may - or may not. Check w/your HR people. It's odd employer would box you in this way - depriving you of four months. Very unfair to its employees if that is way the plan has been structured.
Didn't realize till now there's a Health Insurance forum here - the perfect place for me to ask this question!
Why do insurance plan deductibles go by Calendar Year instead of Plan Year? For instance, if an employer typically has it's enrollment period (the time when they might typically change health plans) mid year, why would your deductible "reset" January 1st? You're missing out on MONTHS in which you could meet your deductible.
I'm in this situation now. I have pretty crappy health insurance through an employer. I became eligible for coverage in May 2015, which is also when they switched to a new health plan. So EVERYONE became eligible in May 2015. The plan is the kind where you have to meet the whole deductible before you get almost any benefits. We've just met the Family deductible a few days ago, so benefits finally kick in but only until the end of the month!
Or are the premiums "supposedly" reduced based on that starting date?
Will your new plan go by calendar year though? The situation you describe is pretty common when a company switches carriers mid-year or if they are trying to line up their fiscal year. I would ask if they have a 4th quarter roll-over this year because of the switch. That used to be pretty common but not so much now, but they might have added it for this year. Some clients I have have a July 1 plan year and their out of pocket costs match that year. One client I have has a Dec 1 plan year but a Jan 1 OOP year and it's very confusing. We've tried to get them to change.....but they won't
Your employer determines when the deductible starts. They can pick plan or calendar year. Employers are free to change plans mid cycle and unfortunately if the deductible restarts, you are just plain out of luck. Good news, the employer can not change the plan again until at least 12 months have elapsed under the new plan.
Your employer determines when the deductible starts. They can pick plan or calendar year. Employers are free to change plans mid cycle and unfortunately if the deductible restarts, you are just plain out of luck. Good news, the employer can not change the plan again until at least 12 months have elapsed under the new plan.
I confirmed that with my plan the deductible does restart when the new calendar year starts. But when you say above that the employer can choose when the deductible starts, if they were starting with a new plan mid-year and they chose calendar year for the deductible to restart, would the insurance company charge a lower premium for the year to reflect the shorter amount of time members had in which to meet their deductibles? In other words, WHY would an employer choose for the deductible to begin when the calendar year begins? The only reason I can think of is that the premiums would be lower for that first year, if in fact they are.
I confirmed that with my plan the deductible does restart when the new calendar year starts. But when you say above that the employer can choose when the deductible starts, if they were starting with a new plan mid-year and they chose calendar year for the deductible to restart, would the insurance company charge a lower premium for the year to reflect the shorter amount of time members had in which to meet their deductibles? In other words, WHY would an employer choose for the deductible to begin when the calendar year begins? The only reason I can think of is that the premiums would be lower for that first year, if in fact they are.
It really probably has nothing to do with the premiums. I am guessing they have always had a Jan 1st deductible year and with the change in coverage, things are just a little off this year. Usually what happens when an employer changes in mid year is that they allow the deductible dollars from that year, so 2015 in your case, to go toward the deductible on the new plan, but I've never seen one roll over into the next plan year. Say someone had surgery in Jan 2015 and met their deductible then, when the plan changed in May, their out of pocket costs moved to the new plan and they were still considered having met their deductible under the new plan, but would then have to start again Jan 1 like everyone else.
I confirmed that with my plan the deductible does restart when the new calendar year starts. But when you say above that the employer can choose when the deductible starts, if they were starting with a new plan mid-year and they chose calendar year for the deductible to restart, would the insurance company charge a lower premium for the year to reflect the shorter amount of time members had in which to meet their deductibles? In other words, WHY would an employer choose for the deductible to begin when the calendar year begins? The only reason I can think of is that the premiums would be lower for that first year, if in fact they are.
There are many reasons behind this, but nobody can say what it is until we know if its a fully funded or self-funded health plan.
It really probably has nothing to do with the premiums. I am guessing they have always had a Jan 1st deductible year and with the change in coverage, things are just a little off this year. Usually what happens when an employer changes in mid year is that they allow the deductible dollars from that year, so 2015 in your case, to go toward the deductible on the new plan, but I've never seen one roll over into the next plan year.
Hmm, the above could be the case, but since I was a new employee and became eligible right when the new insurance plan started, I didn't have anything already paid to a 2015 deductible for their previous plan.
if we start in july and leave end of year can we start a new calander year in a new plan in january
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