My employer offers several insurance plans, including both a low-deductible plan and a high-deductible HSA plan. Suppose my family was planning to have a baby in the middle of next year. Would it be possible to enroll in the low-deductible plan to have it cover the birth and post-birth hospital care and then afterwards use the QLE to enroll in the HSA plan? Or must the change due to a QLE be retroactive to the date of the QLE?

If it has to be retroactive, could I do the reverse? Sign up for the HSA plan and make HSA contributions, then retroactively switch to the low-deductible plan so that it will cover the birth?

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I was in a similar situation, and my HR department has told me that the change has to be related to the QLE. Specifically they told me I could add my new dependent to the plan I was on (retroactive to the date of birth), but I couldn't can't change plans. I don't know how much discretion a company's HR department has in this kind of situation. Also, it was a long time ago.

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    Even if this would work for the OP (which is unlikely; this is a pretty obvious strategy), it would reset the plan deductible and forego HSA contributions while the non-HSA plan was in effect. Also, the plans are unlikely to be the same if the new baby is to be covered after it's born-- extra dependents can be expensive.
    – Upper_Case
    Jun 15, 2021 at 19:16
  • @Upper_Case Yes, for my purpose, the plan would be to make enough HSA contributions after switching to the HSA plan to get to the max for the year. And I'd be ok with resetting the deductible if it was late enough in the year that I figured I could likely make it to January without needing any unplanned doctor visits (since routine care, including the million times you need to bring a newborn in to the doctor, is typically covered 100% even by high-deductible plans).
    – Daniel
    Jun 15, 2021 at 19:46
  • @Daniel I mean, good luck whatever you decide, but even if this would work as you imagine (a big if) it's not very difficult to end up in a worse position due to switching. Your insurer has a lot of people that literally do this for a living; if there were an obvious, easy-to-execute arbitrage opportunity here they would be far more likely than you to be able to address it. That said, opportunities do exist and you may well be able to capitalize on it. Just be careful-- a fair question is "why doesn't everyone do this, all the time?".
    – Upper_Case
    Jun 15, 2021 at 20:08
  • @Upper_Case I'm not claiming this is an arbitrage opportunity. Switching to a high deductible plan is obviously somewhat of a risk. But there are several options for insurance coverage for a reason, and during open enrollment it's up to the employee to decide which policy is best for them. My question here is whether the QLE allows me to switch between options when one of those choices is better for me for part of the year and another of those choices is better for me for the other part of the year.
    – Daniel
    Jun 15, 2021 at 20:41
  • @Daniel I am extremely familiar with health insurance-based risk management, and I'm not sure you're fully appreciating the potential hazards I've mentioned (I may or may not be right about that, and even if I am it may be due to my being unclear). For example, the deductible-related risk is not due to switching to a higher deductible plan but "wasting" your medical spend with the lower deductible plan once it's reset. But I'm trying to sketch out the situation for the benefit of any other users who may happen by this post. The strategy you're describing is fundamentally bad for insurers, and
    – Upper_Case
    Jun 15, 2021 at 20:48

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