Help

[bugsma]

Question:

Am a state employee, and state dropped current health insurance provider, and did not provide a comparable insurance plan. We feel that they should have. Our daughter had regular laser surgeries that the previous provider covered, and we were not offered another provider that would cover it. We were told that we did not have to do anything to have coverage continued, and not to worry about it.

Now, we are forced to stay with the new insurance company until the next open enrollment, with no coverage for what our doctor says is medically necessary.

Any suggestions would be appreciated!

 

[lawrat]

I am a law school graduate. What I offer is mere information, not to be construed as forming an attorney client relationship.

Read what is below (from freeadvice). May want to think about asking employer to pay what not covered as a sign of good faith.

IS A BUSINESS REQUIRED TO PROVIDE HEALTH INSURANCE TO EMPLOYEES?
No. While it is common to provide health insurance as part of employee benefit packages for workers, the law generally does not require a business to do so. However, in the area of health insurance that situation is changing. Specifically, the Federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) will take effect January 1, 1998, and one of the main features of the Act guarantees the continued availability of health insurance, regardless of medical condition, for those already with coverage through employment or otherwise. For this reason, and others relating to court cases and state laws, while there may be no initial obligation to offer health insurance, once health insurance is in place for an employed person it will generally remain available, and this is especially so even now in employment situations governed by collective bargaining agreements.

If an employee loses health insurance coverage as a result of job loss, the employee can often qualify for individual coverage under extension of benefits provisions in the policy or plan or through Federal law mandated "COBRA" extended coverage (which is limited to 18 months normally, or 29 months if the individual is disabled, or 36 months if you are a spouse or dependent of a deceased insured or are divorced from an insured). Employed persons with questions in this area can contact their union or association representative or their company's benefits office.