Questions about Alabama Health Insurance Policy Changes

Q. My employer is changing our group health program to another one with less benefits. Can he do that?

A. Yes. The insurance contract is between the policyholder (the employer) and the insurance company.

Q. Last year, my husband lost his health insurance when he was laid off. Consequently, I listed him on the health insurance plan at my office so that he would have coverage. When he began his current job, I did not notify my personnel office within the allotted time, so I cannot cancel him from the policy until the next enrollment period. When my husband needs to have an exam or some medical work done, is his health insurance coverage through his work considered primary? Can my policy be used to pay the 20% uncovered portion, or is his coverage under my policy useless?

A. If your husband has a claim, his policy will be primary, and yours will be secondary. It would be reversed if you have a claim. If you have any children who are covered by both policies, the primary coverage would be provided by the policy of the parent whose birthday comes first in the calendar year. The other policy would provide secondary coverage.

Q. I want to apply for a conversion policy under my group contract. I have been told I must pay a quarterly premium. I would prefer to pay on a monthly basis. What can I do?

A. Most companies have done away with monthly billing, because it is cost prohibitive. You may want to inquire whether your company will let you pay by monthly bank draft; but,otherwise, premiums will have to be paid in a mode (quarterly, semi-annually, or annually)that is compatible with the company's accounting practices.

Q. I have been covered under my employer's health policy, but now find that my claims are not covered, because my employer failed to pay my premium on time. Is the insurance company obligated to let me know that my premiums have not been paid? What happens to my claim?

A. The company is not required to provide you with updates concerning premiums being paid by your employer. The contract is between the policyholder (the employer), and the insurance company. The insurance company would not be liable for your claim since the premiums have not been paid.

Q. How can I obtain information about the Alabama Health Plan?

A. Please call the Alabama Health Plan Administrator at (800)513-1384 or (334)242-4301.