terminated medical insurance but payed up

[mjohanna]

What is the name of your state? california

What is the name of your state? california

I have worked for this large comporation for 6yrs. On 1/2/07 called to get information about benefits. At that

time was told that my medical coverage was cancelled for nonpayment 12/18/2006 but the cancellation was

backdated to 10/30/2006. I asked them if they were obligated to send me notification that they were cancelling

my benefits and they advised me NO. I also informed them that this was a huge error on their part because I had

paychecks to prove the have been deducting the fees for my benefits since OCT-------Dec. I told them I need this

item resolved today and to reinstate by benefits immediately and back to the date they cancelled. They advised

me it takes time and I would need to appeal the matter.

On 1/3/07 while reviewing my paycheck I discovered that they refunded the money they had deducted from my

checks and issued the credit on my payroll check without notifiying me. I called the benefit center up and advised

them I would mail a check and overnight it but was told not to send any payments in until this matter is resolve

and it should only take a couple weeks. IN THE MEANTIME I have no Medical Insurance. The benefits HQ then

sent me an email that said they take resposibility for the cancellation it was there error and they did recive my

payments but it would take time to get the matter resolved.

What Legal actions can I take against this employer? I needed my medical insurance and have had to cancel several doctors appts due to lack of insurance not to mention the stress this is causing me. HELLLLP

 

[moburkes]

The problem is that you are asking the insurance company to be responsible for the problems that your employer caused. Have you spoken to HR to ask why the insurance was cancelled?

 

[cbg]

FYI, it is quite common for cancellations for non-payment to be backdated. In this case, the last day that was paid for would have been 10/31/06. The insurance carrier would have sent several reminder notices over the course of November and early December, but when they still did not receive payment they would cancel back to the last date for which payment had been made.

The last time I looked, the only state in which the insurance carrier had any obligation under the law to notify you is my own state of Massachusetts. In all other states, that obligation is the employer's.

BTW, unless there have been several other cancellations for non-payment it is entirely likely that if payment is made fairly quickly, coverage can be reinstated. For five years in the 90's, I worked for a national health insurance carrier, and we would allow up to 3 cancellations for non-payment in a rolling twelve month period. As long as they did not exceed that, we'd reinstate coverage, retroactively so that there was no gap in coverage, as soon as we received payment. To the best of my knowledge, most other carriers offer similar service.

If the coverage is not reinstated, the employer will be required to return the payments you have made. ONLY if coverage is not reinstated AND your employer refuses to return the payments you have had deducted can you take any action against your employer. That action would be to report a potential ERISA violation to the US DOL.

It is correct that it will probably take a week or two, to fix. However, it should not take any longer than that from this point unless there is something serious that you do not know about.

Since this is a group policy, the carrier CANNOT accept a check from you and reinstate YOUR benefits only. It's an all-or-nothing issue. Either ALL the back charges are paid and EVERYONE's coverage is reinstated, or no one's are.

 

[mjohanna]

Payments were made

Thank you for your feed back. I was the only one cancelled for medical insurance not all

the employees. NEITHER MY COMPANY or my benfits center or my

insurance carrier ever notified me. I made a general call regarding my insurance and it

was only then that I found out I was terminated. I was out on a leave starting in july and up until october

the benefits company had been making me pay the benefits fee. I made all the

payments. I went back to work in Oct part time and my company took the deductions

automatically from my checks from oct up until mid December. So all of my payments were made

up to

date and I have the proof of those deductions. I have brought this to my HR and the funny

thing is the day after I brought this to their attention I got my normal paycheck with all the

deductions they had taken out for my benefits refunded to me. It just seems a little fishy

that it just automatically shows up? Because of this I contacted my benefits center to see

If i could send the a check for the amount I was refunded. They advised me not too since they haven't invoiced me for a payment. In addition I was never notified

of any payments due or invoiced since Oct according to my records and the benefit center

agreed that the never invoiced me after OCt.



Just an addition this is the third major mistake the company has made in my regard. The

first was withholding my raise and not back dating it. That took six months to resolve and

a threat I would contact the labor board. In addition I am still fighting a battle to get

payment for 3 vacation days that were approved and taken but never paid for and that

has been going on for 4 weeks. Un fortunately due to the amount of time and the amount

of mistakes and enormous stress the company has caused me I hold little faith they are

going to get this matter resolved in a timely manner.

Which leads me back to the question of any legal recourse?

Any government agency I can report them too?

Can I file a small claims lawsuit for all the stress my company is causing?

What do I do about insurance in the meantime? (I have a laundry list of preexisting

medical conditions that no one wants to cover hence I need the group insurance my

company provides. The company refuses to provided me coverage in the meantime even if I offer to pay.

 

[ecmst12]

First, putting extra spaces between the lines of your post makes it very hard to read! Ordinary single spaced paragraphs are fine.

Second, the problem isn't that YOU didn't pay. The problem is that your EMPLOYER didn't pay THEIR bill. YOU making payment won't help; your employer's bill is for ALL the employees. If they don't intend to reinstate coverage, then they HAVE to refund the premiums. They are not obligated to provide you with insurance though, so they don't HAVE to reinstate coverage.

Your employer causing you to have a break in coverage, though, so that you would be subject to any pre-existing limitation on any future policy you get, because they didn't notify you of the impending termination, COULD put you in a position to take legal action, but that's a slow and costly process any way you look at it.

 

[moburkes]

And, your employer is not required, by any law, to backdate your raise. Period.

 

[mjohanna]

Union

They are not required to back date my raise even though my bargained union rights give me a raise at certain designated periods and this was one of those in fact two of those steps of mandatory raise increments.

 

[cbg]

There is no LAW that requires them to backdate your raise, as moburkes said.

If you have a contract that says otherwise, fine. That's a contractual issue. It is still not required by LAW, even if it's required by contract. You can take it up with the union.

 

[mjohanna]

I'd like to thank everyone for all their help!!