"Sorry there is nothing we can do for you." --work benefits

  1. Hello,
    This is Ticklemethu's sister in Law.

    I ran into a problem concerning my benefits at work.
    I started with this company in july. I was told that my benefits will start after 90 days. Months later I was told that my benefit enrollment date had passed & I miss it. So I cannot enroll in my benefit until the end of the year, which meant my benefit will not start until january 1st. Just recently on Dec. 27th, 06, I was admited to the ER for dislocating my right knee. HR is telling me that they cannot help me because I do not have coverage until the 1st of the year.

    My question is: What are my rights?

    It seems as if they are not doing their job. They simply just tell me that there is nothing they can do for me.

    Please help. I have an email ready to be sent out for the HR dept. but wanted to see if I was doing the right thing.

  2. Did you fill out forms when you started to enroll yourself in to their medical plan? Did they have anything in writing that describes what their benefits are and when you're eligible for it? Those are your best bets to prove that you should have been covered their medical plans.
  3. Those people are pretty serious about their enrollment dates. I think you have 30 days to enroll after they hire you on. They should have atleast told you that. Good luck!
  4. I was an HR Director at a small company in the US prior to my current job. You did not say if your employer is based in the US - that's the only law I know - and the advice I can share:

    Re-read the benefit forms you received when you started your job. It depends on the company's benefits plans, but there is a 30 or 60 or 90 day window - called an enrollment period - during which time new employees may opt to enroll onto company benefit plans.

    With most companies (except for some public institutions where employees are automatically enrolled onto health plans) the responsibility for enrollment lies with the employee. If s/he does not enroll during this enrollment period, it is true and it is legal that s/he may not enroll until the company's next "open enrollment" period, which is once/year - OR - if the employee goes through what's called a "life event" where they need to change their coverage. Examples of "life events" are marriage, birth, divorce, adoption, etc.

    So unless your employer is one of those public institutions with automatic enrollment, and you did not enroll during your new employee enrollment period, there is no action a company can take, unfortunately.

    Good luck, I hope something can work out for you.
  5. ^^^100% correct. If you did not enroll at time or hire and/or missed "open enrollment" you were not covered at the time of the admission. It is up to the employee to stay up with these issues.

    I would suggest that you visit the business office at the hospital and let them know you will be paying cash and would like a cash discount and would like payment plans. Believe me, they will get their money, so it's best to work it out with them up front rather than have them chase you.
  6. I will have to concur with previous posters on this one. This is a very common misunderstanding, but with the exceptions already noted by others, in almost all cases, it is up to the employee not only to enroll, but to specifically indicate which benefits he or she wishes to purchase, and in some cases, choose between several different plans.

    Precisely because of cases such as outlined by the original poster, this strategy has been consistently proven to be more profitable for the insurance companies.

    One year, I remember Mr Puff and his fellow employees were required to perform a series of tasks in order to keep the same coverage with no changes - and those who did not were automatically enrolled in the costliest plan, which also offered payment of the lowest percentage of medical care costs!

    That, however, proved not quite as profitable as either management or insurance company had hoped, however, due to a grass-roots employee movement that informed so many people of the requirements that such a large percentage actually completed all the tasks that the tidal wave of paperwork slit the belly of the goose, shattering many an executive dream of golden eggs!
  7. I agree. If you missed the enrollment date and also missed open enrollment, you were not covered when you had to go to the dr. I work across the hall from the state insurance agency, and this issue pops up from time to time. A coworker of mine completed his paperwork when he was hired, but the insurance enrollment forms were misplaced by somebody somewhere. He had his copies, but that didn't matter. He found out he didn't have insurance when his wife had to go to the hospital with a broken foot. He was responsible for the bills, and he ended up being enrolled in an insurance plan he didn't want. He had to wait until the next plan year to change it.

    I don't think there is anything your employer can do for you. Insurance companies are sticklers with those enrollment dates.
  8. This isn't in regard to the insurance enrollment issue, I just wanted to wish you well w/ your knee and insurance issues. I have also had a few dislocated knees and it is no fun. Happy healing.:heart:

  9. thank you ! that was so sweet!! :flowers:

    thank u every one else for the helpful responses also! :yes: