by Guest » Tue Aug 09, 2011 04:53 pm
I have a friend used to work at Robinson's May and when it merged with Macy's in 2005 her Anthem Blue Cross Health Insurance was stopped because she lost benefits. The problem is that she was never notified that her health insurance was stopped. For this reason, she went in for a surgery that she had scheduled expecting her insurance to cover it. There was even a confirmation letter from the insurance that everything was on the go and that it would be covered. Some time after going through with the surgery she was then notified that the payment was reversed and that she was personally now responsible for the $60,000 dollar visit to the hospital. Had she known that she would be responsible for paying this she would not have gone through with the hospital visit. One thing to note is that I believe that Robinson's May did not notify the Blue Cross health insurance that her benefits had been terminated until after her surgery had already taken place. Therefore, I believe that Blue Cross wasn't notified of the two companies merging until after the surgery had taken place. Would it therefore be Macy's fault for not informing her that they had canceled her health insurance? Also, I believe that they merged back in 2005. Does the fact that it happened so long ago have any affect?
My question is: are there any laws pertaining to the health insurance or Robinson's May being legally obligated to notify my friend that her health insurance had been stopped. If she had known all of this would have been avoided. I believe her health insurance was covered by ERISA as well. This all took place in California. Any help is much appreciated. Feel free to email me at garciask8r@aol.com.
My question is: are there any laws pertaining to the health insurance or Robinson's May being legally obligated to notify my friend that her health insurance had been stopped. If she had known all of this would have been avoided. I believe her health insurance was covered by ERISA as well. This all took place in California. Any help is much appreciated. Feel free to email me at garciask8r@aol.com.
Posted: Wed Apr 04, 2012 01:25 pm Post Subject: Health insurance cancelled
See… your friend had the health insurance through her employer. The employer was thus the policyholder. The insurance company is entitled to notify the policy holder (in this case, the company) regarding cancellation of a policy, and usually don’t require to notify the employees directly. The company is also not obligated to inform the employees, and thus your friend was never notified about the cancellation.
However, since your friend proceeded with the surgery after receiving the confirmation letter from the insurance provider, she can charge them for falsification. If she had preserved the confirmation letter and other documents carefully, she can file against the insurance provider in the court. She can even discuss about the problem with her employee.
Posted: Mon May 14, 2012 02:50 pm Post Subject: health insurance terminated no notice,
I work in NJ our health ins. was terminate the first of the for non payment by my employer, never told any of us. Found out by not able to get RX fill. What should be do other than looking for a new job.
Posted: Wed May 16, 2012 08:45 am Post Subject: Health insurance terminated without notice
The insurer must have informed the policyholder, which in this case, is your employer. Lets us have a look at what can be done:
If your employer has deducted the payments from your salary and still not paid for insurance, he has violated the laws.
If your employer has canceled health insurance coverage for all employees (which he may), he is still required to inform all the employees about it. If he hasn’t, he’s in violation of the law.
If the insurance provider has ceased providing coverage in the state, all concerned must be notified about it.
Have a discussion with your employer, and find out which one has happened in your case. If this action has been undertaken to reduce company costs, you’ll have to get individual health insurance policy.
Posted: Tue Feb 05, 2013 10:19 am Post Subject:
Again approach to insurance company first with confirmation letter from the insurance that everything was on the go and that it would be covered. and if they not response file a complain about insurance company.
Posted: Tue Feb 05, 2013 03:48 pm Post Subject:
Please avoid responding to posts that are 18 months old -- especially one that was about a problem which was already six years old to begin with. Your advice in this instance is utterly worthless. Besides, persons who were Robinson-May employees DID receive full notice of their benefit terminations and privileges at the time in 2004-2005.
Posted: Tue Oct 08, 2013 08:06 pm Post Subject: Contractor's health insurance cancelled
I am a Federal employee and my roommate works for a contractor at the Federal employee's office.
As I am sure you know, we are all on furlough at this time and have been since 10/1/13. My friend's boss just called her to let her know that the contractor dropped their insurance and they have not had insurance since 9/30/13. The boss said she thought they had insurance at least until 10/15/13. My friend has had NO notice from either the insurance company or her contract employer regarding the fact that she now has NO insurance!
Is this legal? It certainly isn't fair. Now they are saying she has to go on COBRA or on her husband's policy. I certainly think it is wrong and unfair to not be given any notice at all that she (any many others I work with) have NO insurance!
Please advise.
Thanks.
Posted: Tue Oct 08, 2013 08:57 pm Post Subject:
Is this legal? It certainly isn't fair. Now they are saying she has to go on COBRA or on her husband's policy
If the employer has terminated all employee health plans, then COBRA continuation is NOT an option. HIPAA will allow immediate access to your friend's husband's employer-sponsored or individual policy.Add your comment