Qualifying Event question

For all you insurance guru's out there -
My insurance doesn't cover WLS due to my employer not having the rider.  I am trying to get a revision to DS from RNY (2001).  We tried to pu**** thru as a necessary reconstruction but they didn't go for it. 

Now- my husband's insurance offered thru his employer does cover it.  However, they don't offer open enrollment, which I find crazy!  If you don't take it when hired - that's it unless you have a qualifying event.  They even went so far as to suggest a divorce and remarriage.  WTF

My employer insurance rates are rising, would it be considered a qualifying event if we were to "CHOOSE" not to stick with my plan and switch to his.  I know they say if I "LOSE" coverage. 

I've asked them and haven't got a straight answer and I'm afraid to tip my hand and let them know that I am looking at surgery. 

Any help would be appreciated.  (I am also posting on the DS boards)  THANKS

Jen

I am not a guru on insurance but I had to look at qualifying events last year for my insurance company and I don't remember someone's rates rising as a qualifying event.  But you may want to ask your husband's insurance company to provide you a list of qualifying life events.  That way you know for sure. 

Usually a qualifiying event is a birth, adoption, marriage, or divorce.

Another qualifying event is "loss of other coverage".  This loss could be due to "loss of employment" OR that you are no longer "eligible" for coverage with your current employer. 
Examples:

#1  You lose your job (quit, layoff or fired)... you no longer qualify for health coverage.

#2  Most employer group coverage requires the employer to specify what "class" of employees are eligible for benefits and they have to specify what makes them eligible.... for example, their contract language may read something like this:  All Full-time employees working at least 35 hours per week... or ... All Managers working at least 25 hours per week... 
Here is the key with this option... find out what the contract language reads... if it states you must work at least 35 hours per week to be benefit eligible, ask your employer if they will consider a temporary change in your hours.  You will have to work less than the amount of hours in the contract language  ( you will have  a "change of employment" status / FT to part-time).  Due to the status change, you are no longer eligible for benefits.  You would then be eligible for coverage with your husband due to your "qualifying event" of loss of other coverage.  Explain to your employer why you want to do this. 

Also, you may want to find out what the premium increase will be for you to be covered under your husbands plan.  Sometimes there is a significant increase that you will have to pay out of pocket!  Employers are not required to pay the spouse or children's portion of the premium. 

And, I also want to say, this could be considered by some, insurance fraud.  I am in no way telling you to "lie" to the insurance companies.  I am just letting you know what happens when a situation like the above may come about.  This advice is in no way a guarantee of coverage.... please consult your human resources department or local agent! 

Amy