to cbg

[marleedav]

Hi cbg.

You told me we had a legal right to the SPD (I believe that's what it's called). Anyway, I called Human Resources today where my husband previously worked. She said she didn't have any copies, nor did she ever receive any because the insurance company they are using is fairly new (they switched three years ago). So, who is responsible for sending us a copy of the Plan Summary? The employer or the insurance company? I'm in the process of appealing with Prudential (about my husband's disability), then I will move on with my complaint with the Equal Employment organization you mentioned (to complain about my husband's termination). Should I mention to either party that a copy of the SPD was not available to us?

Thanks,
Marlee

 

[cbg]

In most cases that I'm familiar with, the insurance carrier sends a supply to the employer, who then distributes them to the employees. However, I'm not aware of any law that makes it illegal for the insurance carrier to take that responsibility; in fact, when I worked for an insurance carrier I frequently authorized copies to be sent directly to the employee. Try calling customer service at the insurance carrier and asking them for a copy.

 

[marleedav]

I'll do just that. But, if they don't send me a copy of the SPD, and the employer doesn't....then will our rights be violated since it's a federal law that we are entitled to a copy? Before I finish my appeal and file my other complaint, I want to get my facts straight.

Thanks,
Mar

 

[cbg]

If they are willfully denying you a copy, yes that's a violation of your rights. But if it's just a matter of administrative confusion as to where it should come from, it wouldn't be something to add to your claim. In that case, a call to the state insurance commissioner's office might help clean it up.

BTW, back when I work for the insurance carrier, as I said, I frequently authorized sending copies of the SPD directly to the employees. BUT, it generally took two to three weeks because at least for that carrier, it was print-on-demand. I imagine most carriers do it the same way. So don't expect to get a copy tomorrow, or even Friday - they'll most likely have to have a copy printed up to send to you, rather than taking one off a shelf and putting it in an envelope to go out in today's mail. That's just a guess, but it's an educated one.