open enrollment laws for supplemental health insurance

[cbg]

And the deductions?

If it's pre-tax, the laws are different than if it's post-tax.

 

[necessary]

the personal accident expense plan comes out after tax
the disability rider comes out pre tax

 

[lkc15507]

From what I have read it seems HIPAA is aimed more at group insurance plans and your rights when transfering jobs: keeping insurance, pre existing conditions, what is mandatory to cover etc.

Hey, Steph, I almost had to laugh at this because you are absolutely correct! I try to get folks to understand! But, Thank You! That is EXACTLY what HIPAA (an amendment to ERISA) was all about, as evidenced by the 'P' in HIPAA--"portability". You summed it right up!

As far as AAAFFFFLLLAAAACCC, I am with CBG, you have raised some very good questions. A whole different ball game. Just off the top of my head, we have to look at ERISA first. ERISA would punt regulation of such a plan to your state, I think. Would HIPAA apply at all? I'm thinkin' not (as long as your state provides for any regulation). Sorry I can't answer either, but Cornell University has a very, very good site for the 'by the letter' laws of HIPAA and ERISA (when I find that--my 'puter crashed a few days ago, lost 'my favorites'--I will put them here if I find it). Humm, though, AAAFFFFLLLAAAACCC would be a fully insured type of plan--regulated by your state I think.

You've raised marvelous questions. I'm going to be searching.

Best to you,
lkc15507

 

[cbg]

Stephanie, I finally got a chance to talk to my ERISA expert. Her immediate, off the cuff reaction was no, there is no requirement for there to be a mandatory open enrollment period given the situation you described. When I reminded her that the disability premiums were taken out pre-tax, she conceded that okay, MAYBE in the case of the disability plan, although she really doesn't think so - she really thinks it's mandatory only for medical and dental plans, and even then only for medical and dental plans that are under a Section 125 plan (i.e. premiums taken out pre-tax).

HOWEVER.

Since this is an entirely 100% employee funded plan, your employer has NO obligation to allow AFLAC to come in. In addition, what I told you initially is correct; there does NOT have to be a sit-down, face-to-face interview; even if there is a mandatory requirement, AFLAC can easily and legally do the whole thing by mail. Nothing was stopping them from sending you something in the mail at home or even sent to you at your employer's address, saying essentially, "It's open enrollment time; here are the changes you can make; here are the costs of making those changes; here is how to tell us whether you want to make any changes; here is the date that you must notify us by". So AFLAC's telling you that they didn't offer open enrollment because your employer wouldn't let them come in is a bunch of hooey.

 

[allisoncarter]

hi,

I think that you should contact the agent that sold you your policy and ask her for a copy of her errors and ommissions insurance policy face sheet. You should let her know the error she commited and notify AFLAC that the primary purpose for taking out the policy was to be insured in the event of pregnancy. See where that gets you. Aslo send a letter to her, cc it to AFLAC to your human resources and to your State Department of insurance.

The law if any that you may be reffering to has to do with employment law regarding benefits. You may want to research federal employment law to find the statute tht you are searching for. If not contact an insurance attorney who is speciaizes in that area of law.

good luck.

 

[necessary]

Update. Ok Sorry I haven't been here in a while. turns out I developed preeclamsia and I was rushed to a regional hosipital where I delivered my baby almost 2 months early. Good news is he comes home on Monday I cancelled my AFLAC plans sick of paying people who did a number over on me. I did contact my rep and she said she sent a letter to corporate office requesting them to switch my policy which they of course refused to do. I sent corporate a CRRR letter myself which they never responded to.
Allison, what is a errors and ommisions sheet?
But, basically, to me it's looking like I have no grounds to push AFLAC, besides the rep did a sloppy job, but, I did a slippy job reading what I signed too, so I guess I should bite the bullet on this one? I have no legal ground to stand on. Agreed?
Stephanie (proud mama)

 

[cbg]

Congratulations! Glad to hear you're both doing well.

Stephanie, I have to agree. I don't think there's any legal case here; just sloppy procedures on AFLAC's case. BTW, this sort of thing is precisely why I've never offered AFLAC insurance to my employees; I've heard from too many HR managers about problems with them.