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Dental Coverage: (unintentional) termination

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DentalPost

Junior Member
What is the name of your state? VA

Is a health/dental insurance company required by law to notify a member by letter that his coverage has been terminated?

Recently, my wife had to have emergency dental work and we both believed that she was covered under my employer's group dental plan. Previously, she had been, but was unintentionally terminated by our HR person. I (we) were not aware of this, until recently. In fact, we had received new ID cards (1-2 weeks before the termination), but I never received notice from the health insurance company (or my employer) that her coverage had been terminated.

The termination happened about 6 months ago, and now the health insurance company isn't willing to reinstate her coverage retroactively; nor has my employer offered to cover the dental expenses.

What to do?What is the name of your state?
 


cbg

I'm a Northern Girl
The answer is yes and no.

If HEALTH insurance coverage is terminated, either the employer or the insurance carrier (they have equal responsibility) must send you a certificate showing the beginning and ending dates of coverage within 45 days of the end of the coverage. In most cases, the employer and the carrier decide between them when the policy is first issued, which of the two will do it, since they will be equally held liable if it is not done. Usually it's the carrier.

However, that law does not apply to DENTAL insurance.

May I ask why you didn't notice that the deduction was not being taken from your paycheck?
 

DentalPost

Junior Member
Thanks, CBG.

To answer your question, the reason why I didn't notice the deduction on my paycheck was that previously my empoyer was covering the dental premiums for me and my wife. It was absent minded of me, but I simply presumed that they were continuing this.

Can you cite the law you refer to in your reply?

Many thanks.
 

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