Insurance

[pucker]

What is the name of your state (only U.S. law)? Missouri

My husband is a member of a local union and we have our health insurance through them. WE just found out that as of Aug 1st they cancelled our insurance due to lack of hours for a certain time period. They sent us a letter stating we could pick up cobra that we just got and thats how we found out it was cancelled. When we called and talked to them they said we could make a payment for it and that we should receive that in the mail sometime this week. My question is it ok for them to cancel our insurance without telling us ahead of time? It is the middle of Aug and we are just finding this out and are expected to come up with a big amount of money if we want to continue our insurance with them out of nowhere.

 

[ecmst12]

The policy guidelines say he must work a certain number of hours to qualify for benefits. If he had been keeping track of his hours, he would have known this was coming. The company met their legal obligation by sending out the cobra paperwork.

 

[cbg]

Yes, it is okay for them to cancel his insurance without telling him ahead of time. As indicated above, he should have known that he did not have enough hours for coverage. They are not required to hold his hand.

 

[pucker]

Thats the thing we were told he would be fine and have enough hours to cover him in Aug. In may he had to make a small payment and it was for May-July and they when we did that we didn't have to pay it till the end of may and they wouldn't have cancelled it till after the due date. He also does keep track of his hours but when the employersturn in the hours to the union whenever they want to its hard to keep track of what is submitted and what isn't turned in at the time, but thats another issue we are in the process of taking care of. . I just thought since the cutoff was the end of June they wolud have had time to tell us in advance sine we had no idea that this was going to happen and since in May they gave us to the end of the month to pay it i figured it would be the same way this time not just automatically cancelled. Thanks for the help I appreciate it.

 

[cbg]

I am very, very familiar with this process having worked for over three years at the office of the administrator who handled this for a number of unions.

If he thinks that he has enough hours to qualify, he needs to show the pay stubs confirming it to whoever is administering the plan. Keep in mind that if he does that, he cannot use the same hours for the next qualification period.

 

[pucker]

We wouldn't be able to use those hours for the next period anyways because the cut off was the end of june and the next period will start in july.


I guess the thing that i don't understand is how do they expect us to pay them our self payment and keep it going without having to take cobra if they don't give us the information ahead of time. They don't mail it out till the middle of the month so it didnt give us a chance to make the payment before it was cancelled. The lady said yesterday that they don't know what the amount is till now thats why they can't tell us before hand. Thats why i don't feel what they are doing is right. When we made the self payment in May which was like only 80.00 compared to the 600.0 they want this time. We got the notice in the middle of the month and had time to pay it before it was cancelled. I understand that if he didn't have enough hours its our obligation to pay for it but if they can't tell us what we need to pay before it's cancelled how is that fair or right?

 

[cbg]

How do you expect them to give you advance notice? Do you think that on June 30 they already have the information from the employers as to the hours worked? I am here to tell you that they don't. If they're very, very lucky, they might have about half of the information by July 15. They need time to receive the hours, to compile who has how much, to prepare the information, and to send it out - and the post office isn't exactly Speedy Gonzales.

Personally, I think they aren't leaving themselves enough lag time. But if the dates are as you say and they only have a month between the cut off date and the first date of the coverage, you're lucky if you're getting notified by mid-August. We're talking simply logistics here. It's not something they can put together overnight.

As for using hours in the next period, used to get lots of employees for whom the last date of the pay period didn't correspond exactly to the last day of the qualifying period, which for us was either January 31 or July 31. Say that hours worked on January 29th, 30th and 31st were reported as part of the first week of February (which was quite common). We would allow an employee to add those hours back to the rest of the month of January; however, sometimes they would then come back and want to use them again for the period beginning in February. Obviously we would not let them use the same hours twice; if they wanted them for January we'd let them put them in January, but then they were no longer available for February no matter when they were reported. THAT'S what I was talking about.

 

[pucker]

I understand what you are saying and thats exactly what they said to us. They give the employers till like the 15th of the next month to report the time and that doesn't give them much time to figure it out. Thats why I don't see how its fair. We asked in advance and were told we would be fine. If they can't tell us how much we are going to have to pay ahead of time how is it right for them to cancel the insurance. Thats what i don't understand. If they don't have time to get it together before the cancellation date then how can the expect us to pay it ahead of time. I can't do anything until they give me the info on how much I have to pay.

 

[cbg]

I completely understand your position and I don't believe they are managing the situation well. However, neither bad management nor unfairness is illegal. They are not violating any laws.

 

[pucker]

Thanks alot. I'm glad you can understand what I'm saying. It's not helping that I'm pregnant and high risk and can deliver any day now and now I'm without insurance until I can figure out how to come up with 600.00 for them.