Surrogate delivering at out-of-network hospital and insurance denied Gap Exception

Our surrogate is expected to deliver at the end of December or early January at an out-of-network hospital. She has delivered there before and has care established through that network. It is important that she delivers there.

I contacted UMR and they denied my “gap exception” request. The details were sparse and they basically just said that they already provide that service within the preferred care network and ignored that I don’t really have control of where the delivery is occurring. I saw in another post that I can potentially get a “letter of agreement” where the hospital can agree to provide those services or something like that. We have a lawyer who may also be able to help if necessary (though adds more expense).

If neither of those is an option, I’m assuming the birth is a qualifying event where I can switch to my employer’s insurance and cover myself and the baby (or maybe I’m wrong). The deductible for my plan in-network would be $8000 in-network, co-insurance of 20%, and max out of pocket of $14000. My wife’s out-of-network plan would be a deductible of $5000 (more), co-insurance of 50%, and out-of-pocket max of $29,000. So probably better to be on my insurance if things get expensive. My birthday month and day comes earlier in the year (if the birthday rule thing comes into play).

Thank you!!! Also my wife’s mom just got diagnosed with brain cancer so really need a win!

37, WI, gross income over 200k with wife.