Can my employer cancel my health insurance without telling me?

[Steaky]

My former employer came to me one day and talked about the possibility of canceling our group health insurance policy. Under my benefits package they provided the health insurance at no cost to me. At that time I told them that was fine I would switch over to my wife's insurance but I would need a form from them stating that they were terminating my insurance so that the new insurance, which was under a non-enrollment period, could pick me up instead of having to wait. Months went by and I got no form or was ever told that they had went through with their plan of canceling the policy. A few months after this discussion I found a new job, gave notice and then on my last day asked how long my insurance would continue until due to an upcoming doctors appointment. They then informed me that they had canceled my insurance months prior. Although upset at the time that I had went without health insurance due to the possibility of injury it was not until today when I had my taxes done that I was informed that for the 3 months without insurance that I was fined $243. Should my previous employer be liable to reimburse me for this fine? This is in Missouri

 

[cbg]

Tight call. I can see where the employer went wrong but I can see where you went wrong too. And depending on specifics, possibly even where the insurance carrier went wrong.

Keeping in mind that if you worked for my employer, I'd be the person who provided the letter/form to get your on your wife's insurance, let me ask you a couple of questions. Please note that these questions are for the purpose of determining the likelihood of liability on your employer's part and not to place blame on any particular entity.

1.) How many employees, roughly, does your employer have?

2.) How many employees do you estimate are covered by your employer's health insurance?

3.) How many of them receive the benefits at no cost to them?

4.) How many of them had the insurance cancelled?

5.) Were they notified of the cancellation and if so, how?

6.) Did you follow up on the discussion at any time?

7.) Does your wife's employer have a specific form for adding you to the insurance mid-year or will a letter do?

8.) If a form, did you provide it to anyone and did you follow up about it?

9.) If a letter, did you at any time inquire as to its whereabouts?

 

[Steaky]

Considering we are talking about my former employer:
1.) How many employees, roughly, does your employer have?
10

2.) How many employees do you estimate are covered by your employer's health insurance?
I believe at the time only 3 were being covered, which sparked their idea to cancel the insurance and assist us with ideas to look elsewhere.

3.) How many of them receive the benefits at no cost to them?
All employees were given the option for free insurance as part of the benefits package give at employment.

4.) How many of them had the insurance cancelled?
I cannot speak for them and their situations. With my situation nothing was told to me that they were defiantly canceling it. Nothing written, nothing verbal. I could not go or do anything more then telling them what I needed in order for myself to get onto my wifes insurance.

5.) Were they notified of the cancellation and if so, how?
Again, I cannot speak for their situation, only for my own.

6.) Did you follow up on the discussion at any time?
It is possible that we mentioned in passing that I needed proof from them that they were terminating my insurance so I could join my wifes outside of the open enrollment period. With them giving me no specifics on their plan to move forward or not I felt that it was not my obligation to continue asking for which I just assumed that they decided not to proceed. I needed to focus on my job and not that of others in that situation.

7.) Does your wife's employer have a specific form for adding you to the insurance mid-year or will a letter do?
Her insurance required some kind of written proof that they were terminating my insurance in order for me to join her's outside of an open enrollment period.

8.) If a form, did you provide it to anyone and did you follow up about it?
Again the terminology of form could be incorrect. Form, paper, etc. just written proof that they were not going to continue with my insurance so that I could join onto my wife's outside of the open enrollment period.

9.) If a letter, did you at any time inquire as to its whereabouts?
Again, I feel that it was not my place to have to track the status of this proof that I have asked for, especially when no 100% certain details have been given to me as to the decision that they have made for their plan.

Thank you for the prompt response.

 

[cbg]

Unfortunately, your "feeling" that it was not your responsibility to track or otherwise follow up with that discussion is, IMO, going to weigh very heavily against you. Because of the small size of your employer they are exempt from the employer mandate of the ACA, but you are not exempt from the individual mandate. Therefore you had a certain responsibility to follow up and confirm that you had what you needed when you needed it. You can't dump the full responsibility on them based on your having told them that you would need something for your wife's employer. That was a given; EVERYONE who changes plans mid-year needs written verification that they have lost (or gained) other coverage before they can enroll (or drop) in another plan.

I am not saying your employer is blameless. In my opinion it's a also given that they should have told you definitely instead of assuming you understood. But your lack of follow up makes it, again IMO, something less than a given that they would hold liability for your fine.

It really is a tight call and I can quite easily see it going either way. So you might want to consult with an attorney who can review all of the facts in more detail than a message board can, and see what he or she thinks. A strongly worded letter to the employer might shake them up a bit even if they aren't legally responsible - it may be worth a try. See if the attorney agrees.