Hey everyone,
Haven't posted about this yet, but I'm super stressed and ready to cry.
As some of you may remember, I had a kidney stone the end of March. The next week was DH's last at his then employer. Due to the stone my Dr wanted to run some tests that I knew would be over 500 dollars. But I was concerned as to when our coverage ended. So I told DH to ask his HR rep. His last working day was Tue, April 1. He was owed 3 vacation days, so he asked HR if those would count for our benefit coverage through April 4, the day I was to have the testing done. The HR rep called corporate, who gave their blessing that we would be covered through his remaining vacation days.
A month or so after he left we got a bill from the lab for over 700 dollars stating that our coverage was terminated before the test was done (April 2.) Then we got a notice from the insurance company stating the same.
DH called his HR rep and she sent the question back to corporate. They stated that his benefits did not extend through paid out vacation time, and suggested we apply for cobra (which was running out in a few days.) Cobra would have cost us over 1,000 dollars for the two of us. I drafted a more specific email, reminding the HR person about DH checking before I had the testing done, and asking her who she talked to at corporate that gave the green light. Since we sent that email, she is no longer answering DH's phone calls or responding via email.
I just pulled his paystub for that last week. (He was paid for Mon Mar 31st on a prior stub.) So the stub is for 8 hours on April 1, and 24 hours vacation. The normal amount for half a month's BENEFIT DEDUCTION was taken out of this pay, check dated April 15th.
Does anyone on this site know where I can find employee benefit law, as in how long they have to cover you for benefits they deducted from your paycheck?????
I am so stressed and of course I'm the one handling it. DH has been being way too polite and not pushing the issue. And of course I can't call his HR rep. Though I am ready to call the Cleveland News Investigative reporters and seek their help.
i always thought
medical coverage went by the month...u pay in advance for the next month so even if u would quit on april 1st, coverage would last u until the end of the month bc its prepaid...at least theres normally a few days after ur end date that u still have coverage...they allow u some sort of grace period.
check ur heathcare handbook, if not, call the insurance co directly. at the very least, u hav esomething bc they TOLD u it would be okay. as long as that lady said, i would think its up to her to explain where she got that info. good luck
I called the insurance co
They were nice, but no help. They stated that they have no way of knowing what premiums pay for what time period.
They suggested certified letter to the head of HR at corporate.
That is my next step. I found in the benefit handbook that any pay perid that has thirty hours on it (including vacation pay) is covered so I don't see how they can qualify that vacation time is different than another vacation.
Unfortunately, I think that they will try to ignore us and hope we go away. BUT...if they don't resolve this ten days past our registered letter (and I will put that time frame in it) then I am calling the Cleveland news investigative reporters.
"Om Tare Tutare Ture Mama Ayurpunye Jnana Putin Kuru Svaha"
~Sita Tara Mantra
I would call the HR Dept
I do HR for my company and handle all of our accident, disability and health insurance. With my company's insurance, we terminate coverage as of the last actual working day. Since his final day was April 1, I'm going to assume that was the termination date. They went ahead and paid his vacation days but those weren't considered actual days of work, therefore not eligible to be covered by benefits.
I get spouses calling me all the time, asking for explanations of benefits, etc. You were a covered dependent so you have as much right to call in as your DH! I would actually go in and talk to the HR rep face to face. Explain what happened, what you were told and what you want to happen. The HR person may be willing to go to bat for you with the insurance company and explain that the termination was done on the wrong date. However, you may owe premium for those days (April 2-4?) and depending on what state you are in, there may be laws that protect you. Visit http://www.ohioinsurance.gov/ (I'm assuming that's where you are) for more info.
Best of luck getting this straightened out. I hope you are at least feeling better health-wise!
"I don't know why we are here, but I'm pretty sure that it is not in order to enjoy ourselves."
Thanks Houseof8, that's what they're saying now...
But wasn't what they said when we took the time to verify when our termination date was before I had the tests done. DH sat in the HR woman's office while she called someone from corporate to verify. He explained I wanted to wait on testing, that he didn't want me to because of the fear I could have an even larger stone and get a blockage. But that I would wait if we weren't covered. She said as long as we got it all done by April 4, when the last day of the work week/ and his vacation days ended, it would be fine.
He only even went that far because I told him I wouldn't have it done unless he had it confirmed through HR.
I'm just so angry that they likely gave him an incorrect answer so we're the ones who get stuck. I could see if we had assumed and not checked it out, but I worked in medical offices for ten years and knew better than assume anything. One thing I didn't count on was that HR wouldn't KNOW the correct answer to give us so we could make an educated decision.
DH has an excellent relationship with his former plant manager, and is calling him "off the record" for advice on who to send a certified letter to.
I looked on that Ohio insurance site, but couldn't find anything related to termination of insurance. Every Ohio HR or Union grievance specialist I know, has told me that they are to continue through the last paid premium at the very least. He had paid premiums every pay since his first, even though we weren't covered til he was there 30 days. So we couldn't have been behind, and they took out the full two week's premium on that last pay check, with 8 hours worked (since it goes by month and that Monday was March 31st) and 24 hours vacation pay. All I found by the way of employee benefits info was a booklet that does state if an employee has 30 hours on a paycheck, including vacation hours, they are eligible for coverage. I am looking for any other documents that pinpoint conditions for terminating coverage.
Thanks again for your help. This stuff just kills me. I'm so tired of having to put out fires because of this complicated health care system we have. Why don't we put a system in place where we can buy medical coverage the way we do homeowner's and car insurance. THEN you'd see some competitive rates and customer friendly customer service!
"Om Tare Tutare Ture Mama Ayurpunye Jnana Putin Kuru Svaha"
~Sita Tara Mantra
The world of health insurance
is not a pretty place. I've worked for an insurance agent who was trying to make a living selling insurance and now for a small business owner who is trying to provide benefits without going broke; so I've seen both sides. Was your DH covered by insurance at his new job? Would your $700 claim be payable under the new plan?
"I don't know why we are here, but I'm pretty sure that it is not in order to enjoy ourselves."
He had 45 days til it took effect
He had 45 days til it took effect, then after I postponed all the other appointments to wait on that coverage, his new place of employment's insurance co took a full month longer to even enter us into the system. We were covered and had been paying all that time, with NO info to give Drs. So now guess who's having to run around town two months later asking everyone to re-submit so I don't have to do it all. Anna broke her leg on Memorial day, almost a full MONTH after we were covered and I had no policy number to give the Drs. What a pain. And now, he's been there since the first week of April, I've still not heard anything regarding the dental part of that plan.
My DH doesn't like to follow up, so it falls to me, or me nagging him. It's his one real flaw. I try to keep that in mind when it irritates me
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