Newborn denial

[CRAY]

What is the name of your state? Oklahoma

I recently had a baby. Notified the plan administrator (person who processes claims and does precertification) the day after the baby was born. Notified HR the following week after the baby was born. Both notifications I questioned if there was anything else I needed to do and both said no. Received form in the mail from hospital asking me to verify name, date of birth, baby's name, baby's date of birth, and insurance information. Form stated to be completed and returned within 30 days for insurance purposes. This procedure was done. Approximately two to three weeks later received EOB's showing where doctor bills were applied to deductible. Received two EOB's requesting additional information. Called plan administrator and answered questions. Was then told to have doctor/hospital to refile. Had doctor to refile, claim was paid. At baby's two month check up doctor informed me that baby was still not on my insurance. Called later that day and was informed by plan administrator that they were waiting on a "change/add form" from HR to officially add baby. Up until then I was never told of this form. Asked HR and HR said they could not add the baby because it had been past thirty days. Have been in contact with HR since then and still have not received answer. Can my own employer do this?

[Beth3]

No, HR cannot do this. You had thirty days from the date of the baby's birth to notify them of same and that you wanted to add the baby to your coverage. You clearly fullfilled your obligation. If HR messed up and didn't fill out the necessary paperwork to notify the carrier (or have you fill out any required paperwork), that's not your problem. It's theirs and they need to fix it.

If there's a VP or Director of HR who manages the people you've been dealing with, then contact him/her and explain the situation and ask him/her to intervene to get this cleared up (I promise you that there IS an administrative solution.) If the people you've been dealing with are "it" as far as HR is concerned, then contact whoever your top HR person reports to.

If you can't get this resolved with the employer soon, then tell the top manager you're dealing with on this issue that you'll have no recourse but to contact the federal Department of Labor and file a complaint but that you really don't want to do that. (Be nice about this - you don't want to be perceived as making threats.) If that doesn't get them moving to fix this, then nothing will. If they still don't resolve this, then by all means contact the DOL.