Retroactive Termination

[rachelagogo]

What is the name of your state? NC

I'll try to make this short: My husband has been a part-time on-call employee since March of last year (at Target). We were receiving our benefits thru them and we were paying our premiums out of pocket. (Not taken out of his check).

Things were fine. In Sept we checked to make sure our coverage was active and again in December. Both times they said our coverage was fine.

Last month we received a letter saying his termination date was 7/2/05 and are charging us for all services (and recouping the $ from the dr's offices). This amounts to about $6000 b/c of a hospital stay.

Can they terminate him without his knowledge?--especially when they told us our coverage was fine in sept and dec? Can they take away our insurance retroactively? Target is a self-insured group if that helps any...

 

[mlane58]

Your post is really confusing. Had he been working since 7/2/05? Had he confirmed this with Target?

 

[averad]

From what I can gather the story is in the wrong section (should be in medical insurance) and goes as follows:

* Husband has worked part-time for Target since 03/03/05.
* Received a medical coverage termination notice dated Jan 2006.
* Target is retroactively terminating OP's medical insurance coverage as of 07/02/05.
* Husband still works for Target.

Things we need to know.

* Does your husband still work for Target (If not when did he leave and why)
* What are the requirements to be eligible for health insurance at Target? (Check your benifit booklet).
* Did he take any medical leave or time off?
* Did he work enough hours at work?

Medical Insurance can be retroactivly terminated based on the requirements to hold Insurance. If your husband did not get enough hours at work for example he could be removed for that month (if that was a requirement).

A self-insured groups do not have to follow state mandates, instead they follow federal guidelines. So state laws would not apply, just a fyi.

 

[rachelagogo]

Clarifications

He had worked at Target since 2000 on a full time basis, in July 2004 he went part-time b/c he started a new full-time job. In March 05 he went to an on-call basis. He worked either when he had free time and needed extra money or if they called him to come in b/c someone else had called in sick. He last worked in May, but never quit and was never fired. They would still call him occasionally to come in but his schedule never worked out. I called in September to verify that he was an employee and we had coverage: they said yes. I called again in Dec 05 to verify that he was an employee and we had coverage, they said yes.

We have now gotten a letter saying he was terminated July 05 (we were never informed and I am very confused since I asked as recently as December). They want us to pay back everything they paid AFTER July 05, even though it is apparent that they RETROACTIVELY terminated both his employment and his insurance.

According to our benefits packet, you must work an avg of 30 hrs/week to qualify for health insurance, if you fall below this you will not be eligible for re-enrollment the next year. Since we were already enrolled, we should have stayed enrolled until January 2006.

So, my main questions:
1. Can they terminate his employment retroactively and not inform us for 6 months?
2. Can they terminate our insurance retroactively and not inform us for 6 months?
(Remember I called to verify both were active several times).

Does this make more sense?
I cannot pay the $6000. My premiums were paid through Sept, so I feel like they should not be able to recoup any money from July and August.