The envelope from the district benefits office was sitting on the counter under a Kroger receipt when I got home this afternoon. One page, two paragraphs, and a sentence in bold: coverage under the district plan will end June 30, 2025.
I knew it was coming. When you give notice, you know your insurance goes with the job. But knowing a thing and reading it on letterhead are two different feelings. I sat down at the kitchen table with my coffee going cold and did what I always do when something scares me a little. I opened the green notebook to a clean page and started a list.
What I have right now
For 24 years I've been on the school district's plan, and I've been spoiled. My share of the premium has been $86 a month for single coverage. The deductible is $750. My doctor, my eye doctor and the lab I like are all in network. Greg has always been on his own plan through work, and the kids were on his too until they aged off or got their own.
My last day is June 6. The letter says coverage runs through the end of the month, so I have a little cushion. Good. That gives me about three months to decide something I've never had to decide before.
The options as I understand them
I am not an insurance person. I'm a school secretary who is about to not be a school secretary. So this is just what I've pieced together from the letter, the benefits office and an evening of reading. If you're in the same spot, please talk to someone who does this for a living.
- Join Greg's plan. Losing my coverage counts as a qualifying life event, so Greg can add me mid-year instead of waiting for his open enrollment in November. His HR person said he usually has 30 days from the date my coverage ends to do it. The catch: his employer charges a spousal surcharge of $100 a month if the spouse could have gotten coverage somewhere else. I need to find out whether that applies to me once I'm not working there.
- COBRA. I can keep my exact district plan for up to 18 months. The catch is that I'd pay the whole premium, including the part the district has been covering all these years, plus up to a 2% administrative fee. The benefits office said that comes to about $712 a month for me alone. I nearly dropped my pen.
- The marketplace. Losing job-based coverage opens a special enrollment period. I can apply up to 60 days before my coverage ends and up to 60 days after. Whether I'd get any help with the premium depends on our household income and, I'm learning, on whether Greg's job offers me coverage that counts as affordable.
- Retiree coverage through my pension system. SERS does offer health coverage to retirees, but I'm not drawing my pension yet, and I don't plan to for a while. So that door is closed for now.
Greg read the list over my shoulder and said, "So, mine." Maybe. But I want to see the numbers first, because $100 a month is $1,200 a year, and that's before we even look at what his premium jumps to with a spouse on it.
The questions I wrote down first
Before I call anybody, I want my questions in one place so I don't hang up and remember the important one five minutes later. Here's what's on the page:
For Greg's HR: What does employee-plus-spouse cost per paycheck compared to what he pays now? Does the $100 surcharge apply if my other option is the marketplace or COBRA, or only if I have an employer plan available? What is the exact deadline to add me, and what paperwork do they need? Is my doctor in their network?
For the district: What date exactly does coverage end, and when will the COBRA notice arrive? If I sign up for COBRA, can I drop it later without trouble if something cheaper comes along?
For myself: What do we actually use? I pulled last year's claims. Two office visits, one set of bloodwork, one prescription that costs $9 a month as a generic, and a knee X-ray. Greg is even lighter. We are not big users. That matters when I start weighing a low premium against a high deductible.
And one more, underlined twice: what happens if something big goes wrong in the gap? I don't want even one day uncovered. Whatever we choose, the new coverage has to start July 1.
It's a strange thing to be 55 and doing this homework for the first time. For two decades the district made this choice for me, and I mostly just showed my card at the front desk. I'm a little embarrassed by how little I knew. But I've also spent 24 years helping parents fill out forms they didn't understand, so I figure I can fill out my own.
Next step is the marketplace estimate and a real number from Greg's HR. I'll put both side by side and report back. For now the letter is clipped inside the notebook, and the Kroger receipt is in the recycling where it belongs.
