| Employer provided coverage
What is the name of your state (only U.S. law)? Indiana.
Mid Sept 08, my employer announced we would be changing to a new insurance provider and asked that we report to her by the end of the following wk our intentions to continue w/employer provided coverage and to have new coverage request and coverage interest (medical/dental/vision) paperwork completed by 9/27/08. My employer neglected to inform the employees that coverage with current provider ended 9/30/08, and company chose new provider to start insurance coverage without verifying acceptance of new premiums or service coverage with employees. I have documentation showing employer had not even completed contracting w/new ins co. as of 10/20/08, but plan was to have coverage start date as 10/1/08.
I had $1400 of dental work on 10/1/08. The new ins co does not want to pay the claim, citing not all group members had dental coverage 12 months prior to to starting new policy. New ins co. documents state "A one-year waiting period applies to major procedures. This waiting period will be waived for initial enrollees if this plan is replacing a group dental plan which included major benefits." This statement does not state specifically all grp members were to have prior dental coverage. New plan did in fact replace existing grp dental plan.
So, my question is, where do I start? Do I begin legal action against my ex-employer for failure to provide changes in insurance coverage in the appropriate time or do I file a complaint with the IN insurance commisioner regarding the Ins co. denying my claim? What to do? | 
03-16-2009, 02:26 PM
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