Health insurance issues with HR

[csixx]

What is the name of your state? California

I've worked at and have had health benefits through the same employer for 14 years. Every year they have what's called "open enrollment" for your benefits where you can pick your coverage or waive your coverage by providing proof of other insurance. In 2006, I happened to be on vacation when enrollment was done. I was never notified by Human Resources that I had not completed enrollment nor was I notified that if this matter wasn't resolved I would lose All of my Health benefits. I just happened to find out yesterday when trying to see a doctor that my benefits no longer existed. Is there anything I can do legally here? What I don't understand is, I didn't provide proof of other coverage but I my benefits were waived anyway.

Any suggestions or advice would be Greatly Appreciated.

C~

 

[cbg]

I find it very difficult to believe that you were on vacation for the entirety of the open enrollment period which is usually for several weeks; or that there was no notice of when open enrollment would be taking place prior to your going on vacation. Every place I have ever worked, HR spends weeks if not months making sure employees know WELL in advance when open enrollment will be. I also find that fully half of the employees completely ignore any notices and claim to have had no warning of when it would be. I've even had employees for whom I could pull out a signed acknowledgment, claim they were never notified.

You know that open enrollment takes place every year. It didn't cross your mind until the second half of 2007 that you hadn't been through an open enrollment in 2006? You never noticed, for eight months, that there were no health insurance premiums being deducted?

This isn't HR's fault - this is your fault. HR is not required to take you by the hand and lead you through the process. How were they supposed to know that you did not deliberately choose not to enroll? Providing proof of other coverage is not mandated by law; that's a company policy. They are not obligated to ensure that you have coverage.

Federal law mandates that additions and changes to the plan can only take place when there has been a qualifying event or during the open enrollment period.

 

[csixx]

I'm not trying to say that I am not partially at fault here. I'm just trying to get my coverage back. Let me explain a little further.

For 13 of the 14 years I've worked at this facility, if you didn't enroll, you defaulted to minimum coverage in all catagories. Plain and simple. Everyone got coverage regardless of whether enrollment was done or not. I knew enrollment was approaching, my 2 week vacation had taken place overlapping the 1 week HR was actually doing enrollment. That's the way my facility does it. They want everyone to come, over a few specified days so they can take care of it all at once. I didn't even think twice about it as I believed I would default to minimum as that was past policy for decades.

And no, I never noticed a lack of deductions on my paystub, because I never had any. The facility offers you a certain amount of what they call "flex dollars" which is the money they give you to purchase your benefits. If you stay below that amount, you don't have any deductions.

You are right, it is ridiculous that I didn't figure this out before the 8th month of the year. But at this point, I'm considering it a blessing that I've been healthy this year.

Thanks for your quick response.

 

[cbg]

You will not be able to get your coverage back until the next open enrollment period. As I said, that is Federal law.

 

[csixx]

Last Question

California
If I was being waived, shouldn't I have been given info on COBRA (Cal-COBRA)?

 

[moburkes]

California
If I was being waived, shouldn't I have been given info on COBRA (Cal-COBRA)?

No. You didn't lost your job, nor did you change your hours.

See below:

Qualifying Events for Employees:

Voluntary or involuntary termination of employment for reasons other than gross misconduct

Reduction in the number of hours of employment

 

[cbg]

Under Federal law, since you would have been determined to have knowingly dropped coverage, notification of COBRA is not required. I am not aware of any more stringent rules in CA. Someone more expert than I with CA rules is free to correct me if I am wrong.

 

[csixx]

Thanks everyone for all the info.

 

[baxleykend]

Health Care Savings Account Missing Money

I used to work for a company and recently (2 weeks ago) I tried to pay a medical bill with money that I have been putting into a HSA. According to my pay stub I contributed over $330 to it and only used $52.00 of it. When tring to pay this other bill I found out that I have only $50 left in the account. So far after numberous calls to my former employer's HR dept, the administrators, and the insurance company nobody has been tell me where my money is at. I am currently living in Columbus, GA and have a new job here. I need help in tring to recover my money and if this a matter to take to the Attorney General.

 

[TinkerBelleLuvr]

baxleyend,

Please start your own thread with your own question.