I'm going to bet I'm completely out of luck on this issue, but I wanted to see if anyone had any insight before I file my taxes.

My former employer promised health insurance for all of 2015 (I worked there five years and my position was eliminated at the end of October, and I was promised that my health insurance would continue until the end of November).

We had coverage then early in 2015, our policy was cancelled retroactively, dating back to 10/31/2014. The employer stated that the plan had been dropped due to Obamacare--they said that many plans had been dropped in this fashion and that they (the employer) had not received any cancellation notice, but they were working on getting it reinstated with the provider and that the account manager was working on resubmitting claims that HAD BEEN PAID by the insurance, then retroactively taken back. No employees were aware of the lapse in coverage until they started receiving bills for things that had already been taken care of.

A new provider was found in the interim, and we had about four months of coverage before THAT was cancelled and it was due to reinstatement of prior coverage. So, it looked like things were working out with the previous policy, and according to a live chat I did with customer service early in the year, they were working with the employer to resolve the coverage issues.

We received new insurance cards with a new policy number and were assured by the employer that the policy was in force, coverage was active, all claims were being taken care of. The health insurance website would not update to show the whole policy period that was claimed and I mentioned this dozens of times to the employer, who again swore coverage was active and that they were working with the account manager, who was working on getting that information updated (it was around mid-August by this time). I basically stopped using the insurance altogether since I could never confirm beyond the employer's verbal assurance that there was active coverage. (They swore the premiums were paid and this was all on the insurer's end, but I'm sure at this point that was a lie.)

I received a document from the second provider confirming the four months of coverage for tax purposes, but live chatted with the first provider today to find out whether I had coverage at all... and they said that not only did I NOT, there were no notes on the account that the policy had EVER been intended to be reinstated. So I went 8 months with no coverage at all and now will have Obamacare penalties to deal with on top of everything else.

I had hoped there was some way to fight this in general, but the coverage was 100% provided by the employer... I offered quite a few times to contribute to it, but I suspect they didn't want that since they'd then be accountable for the amounts we paid in premiums if the policies lapsed. And I suspect I will have no leeway with Obamacare fines...

Any thoughts at all? I'm guessing I'm just screwed all around, including with claims that were supposedly resubmitted for payment.

And, for the record, I'm really glad to be away from this employer.

~tmk

I don't think you have to worry about any penalties with employer provided insurance but you do have an issue with your company and or your employer who is responsible for your insurance. I would get a free consult with a lawyer if indeed you had a lapse in coverage or non payments because of it, or make a formal complaint to your state attorney general.

While it's true many insurance companies failed, and employers tried to skirt the law, I don't think you can be held responsible for their screw ups. I hope you eventually get your insurance claims straight, but a lawyer is who can help.

Agreed. I have never heard of a takeback like that and it doesnt even sound legal. The only way it might be legal is if there were promises made between your employer and the insurance company and those promises were never met.

You need to keep track of everything. They should have also provided cobra after your employment terminated if they had active insurance.

So... even though the coverage lapsed, I could still be exempt from penalties since it was supposed to be taken care of and as far as I was told, I did have insurance? That would be phenomenal. Should I maybe speak to a tax preparer or someone else who might be certain of how to handle that? I normally file online with TurboTax and I know last year there was a question about whether you had insurance but not certain how it was worded.

I will certainly make a call to a lawyer and/or the attorney general. I do feel the situation warrants it... it's not right at all to have claim payments taken back months later when all I was doing was using insurance that WAS active at the time according to the website. It's unreal.

I wouldn't be surprised if it was illegal... or never happened the way it was stated. Also doubted any insurance company would do that since they're required to give notice of cancellation ahead of time, but one of the owners said "Oh, yeah, I went to the doctor's and explained what went on and they said that's happened to a looottt of companies, everyone's having trouble with Obamacare and insurance providers are just dropping plans, blah blah..." That never sounded legit, but what was I to do? You don't expect your employer to flat out lie to your face, at least you'd hope not, so all I could do was take it at face value.

I don't have access to my work email anymore, of course, but I did print and save a bunch of promises when they came up because I didn't trust them anymore. Going to go through my records and make some calls tomorrow.

As far as Cobra, it was never mentioned. I was told (in writing, no less, which of course I kept (y) ) that I would have insurance through November and of course found out that didn't happen. I'm not sure I would have been able to afford it but in any case, it SHOULD have been offered... even though it wasn't active and I couldn't have gotten it anyway. I wonder if they realized that (probably did) because I recently found out from a former coworker that a new policy was to go into effect Nov. 1 but "something got screwed up with the enrollment" and they weren't able to start it till Dec. 1.

Monsters, yeah? Lol, thanks so much for your help... the last few months have been an absolute disaster for me.

~tmk

Oh, is there a specific type of lawyer I should speak with? I'm not sure what type of practice would be best to handle employee benefit issues. Thanks!

EDIT: I see now that there are Employee Benefits lawyers and that there's a site where I could try to get a free consultation with a local attorney. I will check that out. :)

~tmk

Quote:

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Originally Posted by themisfitkitten

Oh, is there a specific type of lawyer I should speak with? I'm not sure what type of practice would be best to handle employee benefit issues. Thanks!

EDIT: I see now that there are Employee Benefits lawyers and that there's a site where I could try to get a free consultation with a local attorney. I will check that out. :)

~tmk

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Labor relations?

Quote:

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Originally Posted by ma0641

Labor relations?

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Great, thank you. :)

~tmk

Not sure myself but a FREE consultation of one YOU choose could lead to a referral of a specialist. A consultation is an interview, so be prepared with pointed questions. You are under no obligation to sign a thing, or commit.

Start with a LIST and whittle it down by checking out the lawyer and his firm before hand and be careful with that free consultation they offer as sometimes they mean the first half hour is free, but keep you for an hour.

Yeah it's a freaky process, so do your homework and be diligent before hand. Personally filing a complaint with your attorney general would be MY first action. That can be done immediately. Be careful, and good luck. Let us know how you make out please.

Edited to add; Very good suggestion by Ma0641

talaniman, thank you so much for your detailed answers--you are always so helpful. I also appreciate your suggestion for your first action. I was leaning toward that myself as dealing with lawyers seems very intimidating, expensive, and really, quite terrifying.

One thing I didn't think to mention is that I have contacted the labor board previously on the issue of my back wages still owed and they would not take action due to the company's Chapter 11 filing, suggesting that I seek private council. However, I did get advice previously that maybe the attorney general was the way to go, so I think that will be my first call.