Declining coverage = declining QLE?
My husband and I were on separate employer sponsored HDHP until we had our baby girl January of this year. His was Aetna through Justworks and mine is Cigna. At that point, my husband joined my medical insurance plan but kept his dental and vision plan. He “declined coverage” for medical and got a confirmation email for it. From labor and delivery, I had maxed out our household plan deductible so we were set to enjoy no additional cost for health care other than monthly premium for the rest of the year.
Fast forward a couple months, my husband started PT and claims were getting denied from my medical insurance. EOB said more information is needed. It turns out Justworks still had him covered in a medical insurance plan through Aetna. So Cigna insurance plan became his secondary plan, leaving us having to pay the family premium on Cigna plan AND for the deductibles on Aetna because he didn’t hit his max.
Justworks’ explanation was that by choosing to “decline coverage” he had opted out of a qualified life event and he should have “declined enrollment”.
This doesn’t make sense to us because we got an email confirmation that medical coverage was declined but he is keeping his vision and dental. Has this happened to anyone? Is this even right? What do we need to do to get Justworks to drop his Aetna plan?
We’re continuing to press Justworks but they are refusing to.
submitted by /u/Disastrous_Fox_5272
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