by fuzbuster83 » Wed Apr 25, 2012 06:47 pm
My fiance started a new job in January 2012 and there is a 90 day waiting period for insurance. After her 90 days she applied for insurance but missed the enrollment period for changes and such for current employees. Her employer has informed her she must wait another 90 days and submit her paperwork again. Her 90 days was up on a Friday, her paperwork was submitted on the following Monday, but the paperwork wasn't processed in time somehow?
What can we do because she needs insurance badly to fill her monthly perscriptions for minor things such as allergies which are expensive without insurance,
Shouldn't she be considered a new hire as of her 90 days and as such be given exemption from any enrollment periods?
Thanks, in advance!
What can we do because she needs insurance badly to fill her monthly perscriptions for minor things such as allergies which are expensive without insurance,
Shouldn't she be considered a new hire as of her 90 days and as such be given exemption from any enrollment periods?
Thanks, in advance!
Posted: Wed Apr 25, 2012 07:15 pm Post Subject:
Well, when it comes to enrolling in a group insurance plan, there is a right way and a wrong way to do it. Apparently she did it wrong both times. But something sounds fishy here.
Depending on the employer (20 or more employees), the situation is either governed under the federal law known as ERISA, or it's governed under state insurance laws. If ERISA controls, your fiance can file a complaint with the US Dept of Labor's Employee Benefits Security Administration (EBSA). If not, she can file a complaint with the state Dept of Insurance. She needs to act sooner rather than later. Someone at the company does not know what they are doing to allow this to happen twice, and her employer could be exposed to liability for not having her on the insurance.
Posted: Wed Apr 25, 2012 07:57 pm Post Subject:
Well, she knew when her 90 days was up and she asked them to have the paperwork ready in advance so she could do it that Friday afternoon. Her supervisor submitted it the following Monday morning and the denied her enrollment because they have open enrollment in August and since she is not technically a "new hire" since she had worked there 90 days she cannot get insurance until open enrollment, which will be 8 months after she started.
I'm just very confused by this. The company is a larger company operating a chain of child care facilities 18 states so I would think this wouldn't be so difficult.
Posted: Wed Apr 25, 2012 08:03 pm Post Subject:
Her actual hire date is 1-6-12, which puts her 90th day on 3-5-12, a Thursday. She filled out the papers on Friday 3-6-12 and their on record as being submitted on the following Monday 3-9-12. She just found out for sure today that she will not be getting coverage until open enrollment because they finally answered her back, but she's known about the possibility outcome for about 2-3 weeks.
Posted: Wed Apr 25, 2012 08:32 pm Post Subject:
Alright, what you are describing is known as a probationary period -- the 90 days of ineligibility. What should follow is an enrollment period of up to 30 days. The enrollment period should not be 1 day, and it should not be concurrent with the probationary period.
File a complaint with the Dept of Labor's EBSA using the complaint link you will find here:
http://www.dol.gov/ebsa/contactEBSA/consumerassistance.html
This is an unfair denial of benefits, probably in violation of the benefit plan documents.
Posted: Wed Apr 25, 2012 08:39 pm Post Subject:
Thank you, I will see what the DoL can do for me.
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