Employer terminated my dependants health coverage without notifiying me

[tjmarchel]

During open enrollment I added my husband to our health benifits through my employer. My son and I already had benifits with them. The enrolment form asked me to only list the names and birthdates of the dependants I was adding. I did that. Six months later employee benifits calls and informs me my son was deleted off my policy because I didn't list him under dependants to be added to my policy. We'll I wasn't adding him, he was already on my policy. Now they want six months of premiums to cover the clerical mistake they made. Shouldn't I have been notified he was deleted before six months pasted? My son has seen the doctor several times during this six month period of time for which I had no clue nor did the Insuranse company he was not covered. I dont know what to due , I can't afford to pay the premuims or the bill.

 

[cbg]

Without seeing the actual form and associated paperwork, it's impossible to say whether they made a clerical error or whether you misunderstood the instructions. In any case, it seems clear that they believed, regardless of whose mistake it was, that you were not intending to cover your son on the policy. That being the case, why should they notify you? As far as they were concerned, that's what you were telling them to do. Again, without seeing the paperwork, there's no way to tell whether you or they made the initial error.

Whether you should pay the bill or the back premiums is a decision that only you can make. However, be aware that if you opt to pay the bill and leave him uncovered till the next open enrollment, the insurance carrier legally *may* (I'm not saying they will, it will depend on the insurance contract) consider any conditions for which he has had treatment previous to coming back on the plan a pre-existing condition for which coverage can be limited, if not completely denied. I'm a bit rusty on the specifics when it comes to Federal law, especially since my state uses different time periods, but I believe the look back period is six months. That would mean they *could* legally deny treatment for up to one year, for any conditions for which he had been treated in the six months before he re-joined the policy.