Health insurance not provided as promised

[Roger_b]

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

I am employed by a company with offices in Texas and Florida but no physical office here in Louisiana (in case it matters)

As part of my employment contract, I was to receive 100% employer-paid health /dental insurance after 90 days of employment.

The employer waited 5 months past the 90-day period to send me the paperwork for the insurance. Yes, I had asked them repeatedly to send me the paperwork. I had heart surgery less than a year before and I was very anxious to get this insurance started since I could no longer afford COBRA.

Just a week before I received the paperwork, I had to go to the emergency room. Now, I have just over $5,000 in bills that I should have been covered for.

Here is where the matter stands:
-There is no dispute about the offer of insurance.
-There is no dispute that I requested the paperwork several times over a 5 month period.
-There is no dispute that they delayed in sending it.

Because of this, the company has verbally promised to "take care" of the bills themselves but I really don't believe that they intend to do so. My experiences with this company tell me that they will simply keep delaying the matter until I go away or take some sort of action.

My question is simple. Is there any action that I can take if needed, or is this a lost cause?

 

[JETX]

My question is simple. Is there any action that I can take if needed or is this a lost cause?

If you believe you can prove that they were obligated to provide insurance and failed to do so, you could pursue a 'breach of contract' suit against them. Your damages would be the costs you are forced to pay that would have been covered (above your co-pay and deductible). The question then becomes... are you willing to lose your job over this??

 

[Roger_b]

The question then becomes... are you willing to lose your job over this??

I've considered that question.

The short answer is no and I do understand that I would almost certainly lose my job if I were to take my employer to court.

But if I were to find another offer of employment elsewhere it would be nice to know if I had any recourse against this employer.

 

[Beth3]

There's another angle, which is your employer's group health Plan Document. If you are in an "eligible class" of employees to participate (as defined in the Plan Document) and per the Plan Doc you should have been offered coverage after 90 days, then the employer is in violation of federal ERISA reg's and you may file a complaint with the federal Department of Labor.

It's possible that your employer can get your insurance activated with their carrier on the date that you should have been covered under the plan by claiming a "clerical error." Some carriers are forgiving of that and will let the employer back-date coverage (and pay the back premiums) as long as it's in accordance with that the insurance contract states. You should discuss this possibility with your employer.