What is the name of your state? Texas
I realize this thread might belong under employment law, but I am quite overwhelmed and confused. I also apologize for the length and complexity of my question(s).
I had acquired health insurance and both short term and long term disability (MetLife) insurance through my employer. (But am not 100% positive this brings it under ERISA or not.)
I went on medical leave of absence on 09/29 that my doctor initially stated wuold be for a period of 4 weeks. I received a notice that my short term disability benefits started after my waiting period 2 weeks later on 10/13. The insurance company said they would pay $200 per week, but I had signed up for $300 per week. (I never received a copy of the policy.)
On 10/19 my doctor wrote new information and stated that I would be unable to work for an "undetermined" period of time. I sent this information to my employer and requested an extension of my leave of my absence.
On 10/24 I received - still no check - but a denial of benefits notice dated 10/16 stating that no benefits would be payable beyond 11/1. I wrote a notice of appeal based on my doctor's new information. At that time I also made a written request for the policy since I never received one. I still have not received a copy of the policy.
I received my first check from MetLife for $275 in the mail on 11/3, even though I had completed MetLife's EFT form for direct deposit to my checking account and sent it to them with the claim form.
On 11/3 my employer's benefits coordinator told me verbally that my employment had been terminated effective 11/1 because I could not return to work. I asked her about my COBRA coverage because I need that insurance for my doctors and prescriptions. I have still not received anything. I am now not able to see my doctors or get my presriptions filled and I am very concerned about my long term disability coverage continuing if my short term runs beyond 12 weeks, and also if my employer terminated me unlawfully that I might not even have the long term disability coverage because the guy had said that the disability coverage is not portable when we signed up for it at work.
I requested copies of my medical records on 11/8 because I decided to file a claim for SSDI but haven't received them yet because everything has to go through a central release of information office.
In the meantime on 11/8 I received a notice from my employer that they were terminating my employment effective 11/1 but I can reapply when I am able to return to work. I am not covered under FMLA, because I was not with this employer for a full year, but the EEOC seems to think I might have a legitimate complaint for disability discrimination because requesting a leave of absence is requesting reasonable accommodation whether it is covered by FMLA or not.
On 11/24 I received a second check from Met Life for $485 in the mail - even after telling my case manager it took too long through the mail and they should EFT the funds - AND on 11/24 I also received a notice dated 11/8 stating that they are closing my claim effective 11/22 (2 days before I received the notice) unless they receive additional information from my doctor.
I did file a complaint with the Texas Department of Insurance regarding bad faith practices on the part of MetLife (before I knew anything at all about ERISA) because my claims handler is obtuse. I asked her several times to change my address to a PO Box so I could receive things faster in the mail and to at least have the courtesy to call and let me know if they were mailing the checks instead of direct depositing them, and she flat out refused to do so. Also, she made no attempt to obtain my records from my doctors before denying my claim, and I have to pay for those records, (never mind that I have to get them anyway for SSDI, because that might not have been the case!) MetLife could have requested those records using the authorization forms I had to return to them with my claim form, but my claims handler refused to do so even after I told her they were causing me a hardship. So they could not have denied my coverage for medical reasons, and they have really not even specified to me exactly what "additional information" it is they want.
I would appreciate sample letters if anyone has them that I can or should be sending to my employer or to MetLife regarding non-receipt of both COBRA and insurance policy information, and what are my recourses for them ignoring my requests for this information?
Some step by step guidance would also be appreciated if any is available. Thank you very much in advance and again I apologize if this is in the wrong forum.What is the name of your state?
I realize this thread might belong under employment law, but I am quite overwhelmed and confused. I also apologize for the length and complexity of my question(s).
I had acquired health insurance and both short term and long term disability (MetLife) insurance through my employer. (But am not 100% positive this brings it under ERISA or not.)
I went on medical leave of absence on 09/29 that my doctor initially stated wuold be for a period of 4 weeks. I received a notice that my short term disability benefits started after my waiting period 2 weeks later on 10/13. The insurance company said they would pay $200 per week, but I had signed up for $300 per week. (I never received a copy of the policy.)
On 10/19 my doctor wrote new information and stated that I would be unable to work for an "undetermined" period of time. I sent this information to my employer and requested an extension of my leave of my absence.
On 10/24 I received - still no check - but a denial of benefits notice dated 10/16 stating that no benefits would be payable beyond 11/1. I wrote a notice of appeal based on my doctor's new information. At that time I also made a written request for the policy since I never received one. I still have not received a copy of the policy.
I received my first check from MetLife for $275 in the mail on 11/3, even though I had completed MetLife's EFT form for direct deposit to my checking account and sent it to them with the claim form.
On 11/3 my employer's benefits coordinator told me verbally that my employment had been terminated effective 11/1 because I could not return to work. I asked her about my COBRA coverage because I need that insurance for my doctors and prescriptions. I have still not received anything. I am now not able to see my doctors or get my presriptions filled and I am very concerned about my long term disability coverage continuing if my short term runs beyond 12 weeks, and also if my employer terminated me unlawfully that I might not even have the long term disability coverage because the guy had said that the disability coverage is not portable when we signed up for it at work.
I requested copies of my medical records on 11/8 because I decided to file a claim for SSDI but haven't received them yet because everything has to go through a central release of information office.
In the meantime on 11/8 I received a notice from my employer that they were terminating my employment effective 11/1 but I can reapply when I am able to return to work. I am not covered under FMLA, because I was not with this employer for a full year, but the EEOC seems to think I might have a legitimate complaint for disability discrimination because requesting a leave of absence is requesting reasonable accommodation whether it is covered by FMLA or not.
On 11/24 I received a second check from Met Life for $485 in the mail - even after telling my case manager it took too long through the mail and they should EFT the funds - AND on 11/24 I also received a notice dated 11/8 stating that they are closing my claim effective 11/22 (2 days before I received the notice) unless they receive additional information from my doctor.
I did file a complaint with the Texas Department of Insurance regarding bad faith practices on the part of MetLife (before I knew anything at all about ERISA) because my claims handler is obtuse. I asked her several times to change my address to a PO Box so I could receive things faster in the mail and to at least have the courtesy to call and let me know if they were mailing the checks instead of direct depositing them, and she flat out refused to do so. Also, she made no attempt to obtain my records from my doctors before denying my claim, and I have to pay for those records, (never mind that I have to get them anyway for SSDI, because that might not have been the case!) MetLife could have requested those records using the authorization forms I had to return to them with my claim form, but my claims handler refused to do so even after I told her they were causing me a hardship. So they could not have denied my coverage for medical reasons, and they have really not even specified to me exactly what "additional information" it is they want.
I would appreciate sample letters if anyone has them that I can or should be sending to my employer or to MetLife regarding non-receipt of both COBRA and insurance policy information, and what are my recourses for them ignoring my requests for this information?
Some step by step guidance would also be appreciated if any is available. Thank you very much in advance and again I apologize if this is in the wrong forum.What is the name of your state?