UW has this policy for graduate students who hold a position during the school year and opt into the health insurance and other benefits to also cover the student during the summer after the school year. That sounds great.

But there’s a catch.

Dependents are also covered provided you pay a premium every month that is automatically deducted from your paycheck. This premium extends into the summer which is new to me, though when I look at the available material online it is relatively clear, if buried… We assumed that Robin would be covered during the summer just like me without doing anything. But now that I think about it, it makes sense that we’d have to pay for her coverage.

But for some reason dependents are dropped during the summer unless you pay the premium for the whole summer at the beginning of the summer. This is true even if you also hold a summer position and get a regular bi-weekly paycheck like the rest of the school year. Why they can’t auto deduct from your paycheck, I have no idea.

So, anyway, we did not know this though the GAIP benefits people claim they mailed a letter to us explaining these things back on July 6th. Furthermore, an email was sent to all grad students with appointments on May 18, but I can neither confirm nor deny that since it isn’t in my inbox, trash, or archives. The email (which I was told is also archived online) says something like:

1. You will continue to receive benefits over the summer since you got them during the school year.

2. Dependents are automatically covered also.

3. Oh, btw, you have to pay a premium for your dependents differently than the rest of the school year.

4. If you don’t then actually they aren’t automatically covered…

This basically translates to “dependents are automatically dropped unless you do something even though we start the letter off saying you needn’t do anything to continue to receive benefits.”

What’s most vexing about this is that Robin had a doctor’s appointment for July 5 (which I think she scheduled in June when she was covered, natch). Why would we deliberately opt out of coverage for her when she had a freakin appointment during the summer? The letter was supposedly sent after she had her appointment, too, so we wouldn’t have known at the time that we would have to pay the premium soon for her to be covered.

Of course, the deadline to pay the premium (July 31, afaik) was about two weeks before we received notice from the benefits folks that she was not covered for the appointments she had had. And, of course, she’s had follow-up appointments in the interim which we’ll receive the Explanation of Benefits for probably next month.

How is this acceptable??

So, today I get to craft an appeal letter. Do you think they’ll understand common sense when I tell them that it is obvious we had no idea we had to pay a premium at the beginning of the summer, as evidenced by the fact that we’re having doctor’s appointments and lab work done during the summer? My pessimistic side makes me think they’ll be bureaucratic and we’ll have to appeal the appeal.