Employer Denied Medical Benefits

[Kathy Carpenter]

I'm located in Texas and the day I was hired I was told that after 90 days probation that I could apply for medical benefits.They will not let you fill out the application on your hire date so it is already at the office, but that you have to wait until your 90 days.They do not tell you that there is a time limit of applying after your 90 days and thats what happen to me. I turned my app in a month and a half after my probation and was denied insurance until open registration.I pointed out that they're own company handbook doesn't state that there is a time limit and that they are responsible for the medical bills that I have incurred and they say they are not responsible.It is my resposibility to take care of all the task of making sure that I get insurance.Can they legally do that?

 

[cbg]

Yep, they sure can. It's not unreasonable for there to be a time limit in which you can apply. Usually it's within 30 days of eligibility. You had the responsibility of finding out how long you had to return the form; it's not their responsibility to spoon-feed you. Why didn't you just ask?

In all likelihood, if you are on a fully insured plan it is not your employer who is refusing you benefits but the insurance carrier. How long an individual has to enroll depends on the contract between the insurer and the employer. Both parties have to be in agreement in order to make an exception. In over 20 years of working with group health insurance benefits, I have never once known an employer who wasn't willing to make exeptions, but I've run into insurance carriers on many occasions who refused.

 

[Kathy Carpenter]

Yep, they sure can. It's not unreasonable for there to be a time limit in which you can apply. Usually it's within 30 days of eligibility. You had the responsibility of finding out how long you had to return the form; it's not their responsibility to spoon-feed you. Why didn't you just ask?

In all likelihood, if you are on a fully insured plan it is not your employer who is refusing you benefits but the insurance carrier. How long an individual has to enroll depends on the contract between the insurer and the employer. Both parties have to be in agreement in order to make an exception. In over 20 years of working with group health insurance benefits, I have never once known an employer who wasn't willing to make exeptions, but I've run into insurance carriers on many occasions who refused.

Thank you for your input.I just thought is was strange how every employee ends up being denied insurance for a year instead of 90 days.

 

[justathought]

Not *every* employee, just those that aren't on the ball.