Health insurance primacy

[chd]

What is the name of your state? Texas, California

Hi,

I am working in Texas and have health insurance (Cigna) through my employer, my wife is working in California and also has her own health insurance (UnitedHealthCare) through her employer.

I also have my wife covered as dependant in my plan. This year my wife came to Texas and delivered our first baby here. Since it was in Texas, we did not reveal her own plan and all the bills were paid by my insurance company (Cigna). Our new baby is also under both mine and hers.

Now Cigna is asking a company named "Rwalings Company" to gather our coverage infomation.

Now we know there is some consequence of this, but it already happend.
What will be the exact consequence of this? What can I do to remedy this situation?

Really appreciate your advice. Thanks

 

[cbg]

Probably what will happen is that Cigna will subrogate against UHC for payment of the bills on your wife that UHC should have paid.

Since this is employer-sponsored group insurance you won't lose your coverage. You might get your hand slapped and told not to do it again.

I can't say what your employer will do; probably nothing.

If you want anything more specific than this, you'll need to find your own crystal ball as mine is not working at the moment.

 

[chd]

cbg, Thanks for the response.

Cigna sent me a letter, asked me to fill out the form on back of it and send the filled form to Rawlings company, basically the form asks info for exployment status and other health insurance of both me and my wife. We don't know if Cigna already knows this or not since we didn't real my wife's plan. So should we go ahead to provide the requested info? If we provide this info, mostly like Rawlings will do the subrogation for Cigna, but will any thing happen to us? Will there be any legal action involved? Will there be any financial charge on us? Please, any suggestion is highly appreciated.

 

[somarco]

Two questions come to mind . . .

Why do you carry dual coverage?

Why did you refuse to disclose your wifes coverage?

 

[chd]

Both my wife and I were working in California, so each of us had own plan. Then I got a job in Texas and relocated to Texas, but my wife is still working in California. Here in Texas, I added my wife as dependant, that is why we have two plans.

The answer to the second question is mostly our lack of knowledge about health insurance. We thought the local insurance plan might be better since the baby would be delivered in Cigna's covered area. We were stupid on this decision. Unfortunately, the thing happened.

Does anyone have similar experience that can be shared?

 

[somarco]

Double coverage is (usually) an added expense with very little added value. If both you and spouse have fully paid coverage by employer you MAY see some benefit.

"Hiding" the coverage from your employer(s) is foolish. COB will pay most, if not all of the claims.

As cbg indicated, Cigna will subrogate against UHC to recoup their xs OOP.

 

[cbg]

YES you should provided the requested info! Do you want to be charged with fraud?

It's one thing to make a mistake because you didn't understand how COB works. As I said above, all that's likely to happen as far as that goes is that you get a minor hand slap and an explanation of what you should have done. But now that the matter is out in the open, continuing to hide the second coverage could result in a charge of insurance fraud.

Fill out that form and return it!