Denial of Family insurance

[Erudition]

What is the name of your state (only U.S. law)? IA

My health insurance is an employer contribution. I can't pay for it out of my pocket if I wanted to...

I have worked for this place for 3+ yrs. I have had my boss retire and a new one come in... I recently got married to my long time boyfriend.

I didn't tell anyone I was getting married (not even family). When I came back from vacation I told my boss, and then a few weeks later I informed him my insurance was going to be going up. We mailed the first payment in September for October benies. Just a week ago, I had to send the payment for November benies and he told me he had a problem with my insurance cost.

I've explained to him that this was a condition of my employment when I was hired. I will be the only one in the office not on a family plan. I'm the only female.

I contacted an outside insurance agency and they told me they won't even write up the policy because it would exclude all pre-existing conditions & my husband has several. I've explained this to my boss.

I was off Friday and upon return Monday morning, my boss came in and said that he froze my family plan insurance. I explained my opinion and stance on the topic. He told me that this would in effect be a $2/hr raise for me, and I told him this was promised to me during my original interview in 2006.

What should I do? I don't want to walk out or quit or lose my job but I'm really upset about this!What is the name of your state (only U.S. law)?

 

[pattytx]

Something isn't making sense here. Is this a group medical plan and the employer pays all of it? Or do you go buy your own plan and the employer pays you directly?

 

[Erudition]

We are in a group health fund consisting of 10,000 + people. Due to the cost of the family plan, I called an outside insurance agent to get a quote and was told that it wouldn't even be worth it because of exclusions on pre-existing conditions.

Hope that clarifies!

Missed this part - Yes the employer is required to pay all of the premium...

 

[Zigner]

All you gotta do is whip out your proof that you were promised family benefits!

 

[cbg]

It's a little more complicated than that.

What you need to do is get hold of a copy of the SPD for the policy (they are required by law to provide it at your request, though it may take a few days to order one if they don't print their own and that's okay) and see who is eligible for what coverages. If you fall into a group that is eligible for family coverage, then they must provide it. If you do not, then legally they cannot. They MUST follow the eligibility requirements in the SPD to the letter.

 

[Erudition]

I'm glad you said that, I have several copies here in my office and have copies from every year since I started working here at home!

I checked the pages and can see where they've made a few "mistakes" and in the event my boss doesn't agree to providing the insurance I will bring these up along with other documents I have...

I hate to say it, but sometimes if you don't stand up for yourself no one else will and you will continue to be walked on and treated like a doormat no matter how well you preform. Very sad thing for employees these days.

 

[Erudition]

As follow up, I did contact an attorney. The attorney recommended that I simply write a letter to our Board. I did so, but didn't give it to them as they had already made a "final decision". Their decision was to deny me the coverage (give me single as I previously had).
I contacted the insurance commisioner for the state, who referred me to the DOL. The DOL said that this decision as unlawful and that if my employer did not change this, they would be happy to proceed with a claim on my behalf. This was absolutely FREE.
I informed my employer of this information and at the same time provided copies from minutes of a board meeting prior to my employment stating that "insurance will be provided". I also provided him with copies of the eligiblity rules from my SPD. I highlighted all appropriate information.
He didn't have a word to say. I approached it very calmly and collectively, and simply told him I could either have the DOL contact him or give him the information to contact the person whom I spoke with. He didn't say a word.

I'm still waiting to see if he has the administrator remove the hold on my spouses coverage. I will bring this back up to him in about two days, in an effort to try and be nice about the situation.

I really wish this whole thing never happend!