Question about health insurance

[celestia671]

Hopefully someone can help me on this.

Back in May, I applied for health coverage where I work. I gave the application to the general manager and she told me it would take a month or so to process. Well, about two weeks later, the aforementioned gm was fired and a couple of weeks after that, I was wondering about my insurance. So, I asked my supervisor and she promised to find out and let me know what was going on. Okay, the weeks went by, and every time I asked, I was told they were trying to find out. Anyway, I finally(and I know I should have done this sooner) called the insurance company myself and was told that they never received any paperwork for me! The former gm had obviously not sent in my application.

Well, I assumed that I could just reapply...wrong! The new gm told me that I had to wait until next April because of federal law or something like that. Does anyone know what this law is, and why, if my ap was never sent, I can't just submit a new one? This is very frustrating for me. I've worked for this place for two years, and when new owners took over, I just knew I could get insurance that I've been needing. Should have known that was too good to be true!

:mad:

[Tallison]

1. Find out who the benefits administrator for this

company is and take it to him/her. I'm unaware if there are labor laws regarding this, but have wondered myself, as it's happened to people I know who never did the legwork to get to the bottom of the matter. I expect you can still get it if you're willing to make a case for yourself in the form of phone calls and letter writing. I learned the hard way to take the initiative where payroll and benefits are concerned. It's not that benefits administrators are out to screw people so much as they're overwhelmed, too, and you need to get on them to make the phone calls necessary to get the exception. I work with health insurance companies staffed by half-comatose people, and badgering and persistence and follow up and going up the ladder makes all the difference in judgment outcomes.

Best of luck.

[celestia671]

2. That's the problem...

we don't have a person in charge of stuff like that. It's a hotel that's managed by a coroporation, but there's just the gm, assistant gm, and various department managers.

[Tallison]

3. If they they offer benefits, there has to be

a benefits administrator, probably affiliated with off-site human resources. They may outsource or subcontract this function to an independent agency, but to the extent they're providing the service to your hotel's employees, they're the go-tos for this issue. I wouldn't expect the GM or managers to even know much about that aspect of the corp's bureaucracy, it's such a specialized function.

[cassiepriam]

4. Have they taken the premiums out of your paycheck?

Sounds like fraud to me. Taking money for health care, then not delivering. I would go to the head of HR and complain. Then I would go to the state insurance commission and see if you can file a complaint.

PS I am pretty sure your company can fix the problem.
It is their mistake, they need to make it right and I have seen
other cases where it has been taken care of quickly. (I work with
with health insurance every day. )

[celestia671]

6. No

but what is this federal law they referred to?

[cassiepriam]

7. I have not heard of this federal law..

It does not mean it does not exist. I work on the health
care side of insurance not the legal end of it.
But I agree with the other poster who said that if it
is the companies fault, not yours, it can be fixed.

[pitohui]

11. it isn't a federal law

many company health insurance plans have a yearly enrollment period, you have to enroll in that month or you're not enrolled for another year

it is not a law

it is simply their insurance policy contract

however, since the employer effed up, i think they have an obligation to provide alternative insurance coverage to the employee until the next enrollment period opens in april

they're prob. telling this employee any ol crap to cover their ass because of their screw-up

the employee may end up needing an attorney, she certainly will if she ends up needing expensive health care bet. now and april

[cassiepriam]

13. With insurance companies the rules are made to be broken....

when it is in their interest. So we know that the polices
are flexible. I do not think a attorney is necessary. I think if
this lady starts making enough noise the employer will fix the problem. And yes they are blowing smoke up her behind to cover themselves. Nice employers, they lie to her in the beginning promising her health covariate. then they lie to cover up the fact they are not giving what they promised. by citing a law that does not exist. The supervisor who was fired was incompetent, that is most likely why he was fired. But it is up to the company to sort it all out now for this person and get her the benefits they promised her.

[cassiepriam]

8. I have not heard of this federal law..

It does not mean it does not exist. I work on the health
care side of insurance not the legal end of it.
But I agree with the other poster who said that if it
is the companies fault, not yours, it can be fixed.

[cassiepriam]

9. PS be very assertive and do not take no for an answer...

that usually works. Seems to me that if they promised
you health insurance and then did not deliver it then they
are at fault, and hired you under false pretenses. I would
make some noise.

[LaurenG]

5. This happened to me.

Call the insurance company and explain what happened. There is an enrollment period that is set by the company and employer. Sometimes they will enroll you when the problem was NOT because of your error. They let me enroll but I had to pay four months worth of premiums (the time I should have been paying the insurance company). Your immediate supervisor should handle this for you. I hope that it all works out soon.

[pitohui]

10. so you can't get sick or be in an accident until april

i'd either get a lawyer or a new job or prob. both

there's something wrong, if you were a valued employee, you'd have the health insurance, if you have a skill of value, start looking for a place where it's appreciated

yes, there is yearly enrollment but you've been working there for 2 years so i think they have a duty to fix this, either that, or you end up suing yr employer if you have a big health care bill before you can enroll

me, i'd be very much looking for alternate employment

[raptor_rider]

12. Something smells fishy!!

I help out our employees with their insurance applications and with the renewal every year with Blue Cross Blue Shield. The company has the probation period picked. Whether it be 60, 90, or 120 days. Within that probation period, the employee is asked whether they want on the company health insurance or not. If they do, the the employee fills out the application and either they mail it off themselves or gives it to the person that handles the insurance and they mail it off.
Now it seems that the prior GM didn't follow through with mailing off the application. Now the new GM says that you have to wait?? I call Bull Shit on this one. For a company to keep their premiums low, they have to have a certain percentage of the employees on the health insurance. Not only that, since the application has not been mailed off, one should be mailed off a.s.a.p. to get more on the insurance, to keep the costs to the company down. Sounds like to me that the new GM is a lazy person and does not know what procedure is and that the prior GM didn't a rats ass, as to where they probably knew that they were out the door.
I would go over their head and go to someone higher up and complain and bring up some points that the application was never sent off to begin with and with that fact that it should be sent off now with a retroactive date attached.

[NewJeffCT]

14. you should be able to re-apply

Most places allow exceptions for life-changing circumstances - i.e., marriage, childbirth, divorce - and, while not as dramatic as that, it is the company's fault the paperwork was not submitted and not your own (I assume you have a copy of the paperwork you gave your original supervisor?)