Not sure, but this is about health benefits

[lisan23]

What is the name of your state? Utah

I got a job with Convergys, Corp. while I was pregnant with my daughter. I took the job so I could get health benefits as my husbands job did not provide them. My daughter wasn't due until mid-April, but I was involved in two accidents during my pregnancy, the second of which caused me to start going into early labor. Because of this issue I ended up going on maternity leave in mid-March. I had my daughter on April 1st. I didn't sign or put through any of the papers for my maternity leave, my supervisor did because at the time I wasn't on bed rest, but I was supposed to avoid being active as much as possible. He told me it was all taken care of. Well, two weeks after having my daughter I was informed that my health benefits were cut off on March 31st so none of my pregnancy or birth was covered.

Do they have to give me notice of when the benefits would end before they ended? Is there anything I can do to make them cover it? I've already called HR, the insurance company, and physically went in and everyone says there's nothing they can do for me. Finally, is there a statute of limitations on this - as this took place two years ago? (I had never thought of taking legal action until recently. I'm not sure why it took so long for it to occur to me.)

 

[cbg]

What was the reason they gave you for the cut off?

You may very well have waited too long, but the reason they provided might make a difference.

 

[ecmst12]

They don't have to maintain your benefits while you're on FMLA (or any other unpaid) leave, but they DO have to notify you and give you the opportunity to sign up for Cobra within 60 days of the termination of benefits. Which it doesn't sound like they did.

FMLA wouldn't apply of course since you weren't employed for a year prior to the leave, but that's not really important.

When did you find out about the termination of benefits? And did you get papers offering you Cobra coverage?

 

[mlane58]

They don't have to maintain your benefits while you're on FMLA (or any other unpaid) leave, but they DO have to notify you and give you the opportunity to sign up for Cobra within 60 days of the termination of benefits. Which it doesn't sound like they did.

FMLA wouldn't apply of course since you weren't employed for a year prior to the leave, but that's not really important.

When did you find out about the termination of benefits? And did you get papers offering you Cobra coverage?

ecmst---They most certainly do have to maintain benefits, it is up to the employee to continue their portion of the premiums.

 

[cbg]

At least as far as FMLA is concerned, the statute specifically states that the employer DOES have to maintain benefits.

While technically, if FMLA does not apply, the law is not going to force the employer to maintain benefits (at least in most states) administratively it is FAR more trouble to cancel benefits, offer COBRA, reinstate benefits under COBRA and then when the employee returns, cancel COBRA and reinstate benefits under the main plan. An employer would have to be a real anal-retentive to go through all that instead of just leaving the employee on the main plan to begin with. They lose what, the two percent administrative fee?

 

[ecmst12]

I probably misread the site, they don't have to maintain benefits AT THEIR COST though right? But again since it wasn't FMLA, that doesn't help the OP very much.

And some employers are in fact anal retentive jerks. Haven't we seen enough proof of that here?

 

[moburkes]

I probably misread the site, they don't have to maintain benefits AT THEIR COST though right? But again since it wasn't FMLA, that doesn't help the OP very much.

And some employers are in fact anal retentive jerks. Haven't we seen enough proof of that here?

No, they are not responsible for the payments.

 

[cbg]

Under FMLA, the employer must maintain benefits exactly as if the employee were working. If the employer pays 100% while the employee is working, the employer pays 100% while the employee is on FMLA. If the employer pays 75% while the employee is working, the employee pays 75% while the employee is on FMLA. And so on. This is mandated by statute. ONLY when FMLA is exhausted can the employer legally require the employee to stand the full cost.

http://www.dol.gov/esa/regs/compliance/whd/whdfs28.htm

 

[moburkes]

Under FMLA, the employer must maintain benefits exactly as if the employee were working. If the employer pays 100% while the employee is working, the employer pays 100% while the employee is on FMLA. If the employer pays 75% while the employee is working, the employee pays 75% while the employee is on FMLA. And so on. This is mandated by statute. ONLY when FMLA is exhausted can the employer legally require the employee to stand the full cost.

http://www.dol.gov/esa/regs/compliance/whd/whdfs28.htm

This person isn't FMLA eligible.

 

[cbg]

I realize that. But the responses on this thread seem to be saying that even when FMLA is involved, the employer is not responsible for the payments, and that is not correct.

That may not have been the intent of the responses, but that is what's coming across.

 

[lisan23]

The reason they gave me was because I went on maternity leave in March, and benefits end in the month that you take your maternity leave. I realize it might be too late, but if it's not I would really like to get something done about it as this has ruined my credit as well as my husbands because having a baby in a hospital is expensive, and ALL of my pre-natal visits weren't covered as well.

COBRA was never offered, but I'm not sure if that applies. Thanks for the responses, though.

 

[cbg]

Since FMLA did not apply, they had no legal obligation to continue your health insurance benefits. However, if they had 20 or more employees for at least 50% of the previous year, they were required to offer you COBRA.

The problem is that I believe (I'm not 100% certain) that you've already passed the window for filing a COBRA violation claim. If that's the case, then you might have at one time been able to either get them to pay the bills or else retroactively provide you with coverage, but you've waited too long. It's certainly worth checking with the US DOL about, but I think the SOL is 2 years.

 

[lisan23]

Thanks! I figured I'd probably be out of time but it's worth a shot.