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complicated health insurance problem

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pelletized

Guest
What is the name of your state? pennsylvania.

I received in the mail, after working at my current job for a few months, a packet of information pertaining to open enrollment for health insurance. i eagerly signed up, as health insurance wasn't even mentioned when i was hired. around the same time, i received a letter about COBRA from my previous employer, which i decided i didn't need since i had been promised health insurance. i received letters of confirmation and my health insurance card shortly after. this all happened in oct. - nov. of last year, and i was fine until i sprained my ankle in june and had to go to the emergency room. when i told my boss what happened and mentioned i was glad to have the medical benefits, she then informed me that in fact i was not eligible for medical benefits because i am only part time at that job. when i asked about all the money that they were supposed to be taking out of my check each week for my insurance, it was researched and found that no money had ever been taken out. a call to the insurance company revealed that i was never set up for an account with them, and that i was sent the insurance enrollment forms "by mistake." thats all well and fine, and certainly i can appreciate that mistakes happen, but on occasions where i am at fault i make every attempt to correct the situation, whereas my complaint was met with a "there is nothing we can do" from both the insurance company, and my employers. all of this would have been avoided and the bill out of my mind and completely taken care of if i had signed up for COBRA from my previous employer, but i was misled into thinking that i was covered by my new employer. the insurance company told me to speak to the human resources department, which i certainly will do when i next go into work, but is there anything i can do until then?

sorry this is so long!
 


Beth3

Senior Member
Perhaps cbg (regular poster with lots of benefits experience) will have some ideas but I'm sorry to say I think you're SOL.

Yes, the employer messed up by mailing you the open enrollment info. Obviously the mailing list wasn't screened well enough. On the other hand, you were well aware eligibility for health insurance had never been discussed when you were hired. It's reasonable to assume that you knew you weren't eligible for it because you were part-time.

Absolutely the employer messed up but you also made an error too by not contacting HR and saying "I just rec'd this info and I want to double check on my eligibility since I wasn't told I'd be receiving health benefits when I was hired." The company made a mistake but a 30 second phone call on your part could have rectified the whole thing. Plus, you never followed-up on the premium deductions that weren't being made from your check. Had you done that timely, you might still have been within the time line to make a COBRA payment and keep on the other plan.

I think the choice you made here was not to look a gift horse in the mouth and unfortunately, now you're paying for it.
 
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CIAA

Guest
Beth is right, and of course the problem is further compounded by the fact that no premiums were deducted from your paychecks, further putting you on notice that their was something wrong with the coverage being in force.
 

cbg

I'm a Northern Girl
I agree with Beth and CIAA. The company messed up, but so did you by not checking into it. The fact that no money was being taken out of your check should have tipped you off to the fact that something was wrong.
 
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pelletized

Guest
yeah, that's what i figured. still, it never hurts to ask! thank you for your replies.
 
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bowler87

Guest
The good news is that with the money you saved by NOT signing up on COBRA you can pay for your ankle injury. COBRA coverage is very expensive---$700 month?

Time now to review your insurance situation.
If your car is stolen tonite is it covered?
If your clothes and TV and stereo are stolen are they covered?
If you die what life insur will pay your family?

If you had to have surgery in September 2003, would you get some insurance now or wait until August 2003?
 
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CIAA

Guest
Cobra cost is limited to the cost to the employer + 2% admin fee.
 

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