health insurance question

[R.Holland]

California,

A long story but here goes.

I approached my employer, AlliedBarton last February to try see if my girlfriend being laid off was a qualifying event to start my insurance policy without an open enrollment date. I was put in contact with a Rep from the HR department, and she took my info and responded the next day, saying that my situation was not a qualifying event. We went back and forth, but eventually she told me I would need to wait till January 2010 to insure my son. In the mean time since then, I've gone to court to try to get visitation rights to my 5 year old daughter. In the court order I was ordered to provide insurance. The court order reached Allied and I recieved a packet and rate notification from them. I emailed the HR rep back last night confused about the process, and asked if I could now add my son to the policy. She responded with the number to the "Allied Barton Benefits Hotline". I called them to ask, and recanted this series of events to them. The rep said that I couldn NOT add my son till January. Then she stated that my event in February did qualify me for mid year enrollment and that I should have been allowed to enroll. I said that I dealt with Janet Melendez regarding the problem and that she never mentioned a benefits hotline, and handeled the issue herself. I asked if since i was misdirected was there any recourse. She said no, and the conversation was quickly brought to a close, by saying " your only options is to wait till january". What are my legal options? HELP!

-Ray

 

[cbg]

To wait till January.

 

[R.Holland]

How could their gross neglect leave me with no legal options? The first person I spoke with gave me a wrong answer, and thats just ok? That doesn't make any sense.

 

[Zigner]

The court order should be enough to allow you to add the child...

 

[CourtClerk]

The company MUST enroll the child with the court order. You.... you'll probably have to wait until January.

 

[R.Holland]

I think theres a misunderstanding. I know the explanation was a little wordy, so let me clarify. There's 2 children in question. The first HAS been enrolled, the question is what are my rights to have my custodial child <that Ive been trying to enroll since February> enrolled on the new policy that was started for my non-custodial child.

 

[ecmst12]

They CAN NOT enroll anyone outside of the 30 days following a qualifying event or during open enrollment. It doesn't matter whose mistake it was that you were told the event wasn't qualifying when it was (the event was actually the child losing other coverage, not child's mom losing her job), the 30 day window is IRON CLAD and can't be gotten around for any reason. It's in place by federal law and nothing trumps that.

 

[cbg]

A court order to provide coverage is binding on you. It is not binding on your employer. They are not obligated to violate their plan document to provide coverage to your child.

Is the child you are trying to cover your biological child, your step child, or your adopted child? If anything but your biological child, is he your girlfriend's child? Do you and your girlfriend live together? Does your plan document allow for the coverage of domestic partners? What coverage did the child have prior to February 09?

There is a specific reason I am asking each question, and to give you the best possible answer to your question I need the answer to all of them.