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Loss of health benefits

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dtm1966

Junior Member
What is the name of your state? Texas

I had group insurance through my employer as a full time employee since 2/1/01. It is a small business with less than 15 employees. They took a deduction from my paycheck every 2 weeks to pay for the coverage (I believe this was approximately half of the premium and the business picked up the other half). On 2/11/04, I was informed by my pharmacy that my health insurance had been dropped. When I called my employer he said the insurance company had dropped our coverage for non-payment. He denied ever receiving the notice of cancellation from the insurance company sent on 2/3/04. The insurance company told me he had not paid since November and that the policy was dropped on 2/3/04 retroactively so that the official date of cancellation was 12/1/03. They say they sent late payment notices to my employer but no information was ever sent to the actual policyholders. They stated it is also their policy to give employers a “few months” to “make things right” but if they don’t, they cancel the policy retroactively.

My employer reimbursed me in my March paycheck for the premiums which had been deducted from my pay check for insurance I never received.
Would it be a waste of time to sue my employer for the cost of some significant medical bills I had in January? (Most of the additional cost was because of the difference in negotiated cost my insurance company had for the tests and the cost if you have to pay if you have no insurance).

I also lost the chance to get continuing coverage due to the fact I was not informed until 73 days after the insurance was cancelled. I need to go have a check up for a pre-existing condition next month and know the insurance I have now will not cover it. What are my chances of suing to getting the difference in cost associated with these bills too? My former employer has shown no regret over his treatment of me so I know he will fight doing anything.

Thank you
 


Beth3

Senior Member
Would it be a waste of time to sue my employer for the cost of some significant medical bills I had in January? Pretty much. Your employer is not obligated to provide insurance benefits to you and they did refund the premium deductions (eventually.)

I also lost the chance to get continuing coverage due to the fact I was not informed until 73 days after the insurance was cancelled. The health plan was cancelled due to non-payment. There was nothing to continue. COBRA continuation reg's only apply when the employer's group health plan remains in force. That is not the case here.

The one thing you did miss out due to untimely notification from your employer on was the pre-existing condition limitation under HIPAA, which it appears you're aware of. You certainly may speak with an attorney if you wish to but unfortunately, I strongly suspect you're SOL. Sorry.
 

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