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Started By
Message
OT lawyers: health insurance issue. Please help.
Posted on 9/10/19 at 9:17 am
Posted on 9/10/19 at 9:17 am
InB4 ‘you’ve come to the right place’, but I’m honestly at my wits end and frustrated.
So I get married earlier this year, and add my wife (no pics) to my insurance. It all looks good, in our ‘employee navigator system’, etc. I make sure to as our company’s contracted HR person multiple times if there is anything else I need to do since it’s only a 30 day window. She says everything is good.
Last week, my wife needed to go to the doctor and we find out she’s not on my plan. She’s basically uninsured. I start making phone calls and it turns out the broker dropped the ball and didn’t forward along the righ info to the insurance company. They admit the mistake (in writing) and said it’ll be fixed within 24 hours.
Fast forward to today and she is still not on my plan. The broker had to resubmit the paperwork and now waiting for the insurance company to review and decide whether or not they’ll allow it or force me to wait until an open enrollment period. Insurance company said it’ll take a few days minimum. My wife needs to go to the doctor!!!!!
I’m not one to run out and seek legal action, but what can I do???? This is no fault of my own and 100% the broker’s f*** up, but I’m paying the price for a slap fight between the insurance company and the broker now.
....not to mention my wife being currently uninsured.
So I get married earlier this year, and add my wife (no pics) to my insurance. It all looks good, in our ‘employee navigator system’, etc. I make sure to as our company’s contracted HR person multiple times if there is anything else I need to do since it’s only a 30 day window. She says everything is good.
Last week, my wife needed to go to the doctor and we find out she’s not on my plan. She’s basically uninsured. I start making phone calls and it turns out the broker dropped the ball and didn’t forward along the righ info to the insurance company. They admit the mistake (in writing) and said it’ll be fixed within 24 hours.
Fast forward to today and she is still not on my plan. The broker had to resubmit the paperwork and now waiting for the insurance company to review and decide whether or not they’ll allow it or force me to wait until an open enrollment period. Insurance company said it’ll take a few days minimum. My wife needs to go to the doctor!!!!!
I’m not one to run out and seek legal action, but what can I do???? This is no fault of my own and 100% the broker’s f*** up, but I’m paying the price for a slap fight between the insurance company and the broker now.
....not to mention my wife being currently uninsured.
This post was edited on 9/10/19 at 9:19 am
19
Posted on 9/10/19 at 9:18 am to BabyTac
pics of your uninsured wife?
Posted on 9/10/19 at 9:19 am to BabyTac
The doctor will be cheaper without insurance unless you’ve met the new much higher family deductible.
Posted on 9/10/19 at 9:19 am to BabyTac
What is the urgency for her getting care?
Posted on 9/10/19 at 9:21 am to BabyTac
First of all, get her to the Doctor regardless, tell the doctor that insurance will need to be billed when corrected and let it play out.
Posted on 9/10/19 at 9:21 am to BabyTac
So go to the doctor.
Posted on 9/10/19 at 9:21 am to Beessnax
Her knee is killing her. Hurt it playing tennis. It’s not an emergency but needs to get looked at.
Posted on 9/10/19 at 9:21 am to BabyTac
Have you considered looping in your employer’s HR? That’s kinda why they are there.
Posted on 9/10/19 at 9:22 am to BabyTac
Maybe spend $200 or so and get an attorney to fire off a scathing letter.
I have no clue if you can recoup that 200 though.
Maybe approach your company and ask them how they want to handle your wifes medical costs until they get THEIR failure corrected.
They'll probably pay
I have no clue if you can recoup that 200 though.
Maybe approach your company and ask them how they want to handle your wifes medical costs until they get THEIR failure corrected.
They'll probably pay
Posted on 9/10/19 at 9:23 am to BabyTac
Go to doctor. Pay cash rate. Seek reimbursement later, if you want. The broker will straighten this out. If they do not, you can sue them for any losses due to no insurance.
You will be fine - just hold tight.
Most people will fix mistakes without being sued.
You will be fine - just hold tight.
Most people will fix mistakes without being sued.
Posted on 9/10/19 at 9:24 am to BabyTac
I'm not sure if this is helpful or not...but maybe your employer has this..
Every single year, our broker tries to sell us coverage for this exact scenario. We always decline...but coverage for benefit enrollment error is a thing....just something to ask about...
Every single year, our broker tries to sell us coverage for this exact scenario. We always decline...but coverage for benefit enrollment error is a thing....just something to ask about...
Posted on 9/10/19 at 9:35 am to BabyTac
You'll likely pay more for a lawyer than paying out of pocket for the doctor's visit and any results a lawyer will be able to get for you will likely take considerably longer than waiting on a response from the insurer.
Posted on 9/10/19 at 9:36 am to BabyTac
quote:
....not to mention my wife being currently uninsured
No, you definitely mentioned it.
Posted on 9/10/19 at 9:36 am to BabyTac
quote:
Her knee is killing her. Hurt it playing tennis. It’s not an emergency but needs to get looked at.
I'll look at it! Just send pics...Preferably in a tennis dress.
Posted on 9/10/19 at 9:44 am to BabyTac
The broker has Errors and Omissions insurance. Tell him to write a check or make a claim on his insurance to cover whatever medical expense you incur until she is covered. It ain’t complicated. I am not a lawyer.
Posted on 9/10/19 at 9:52 am to BabyTac
Why is the broker forwarding the info to your insurance provider and not your employer's HR? Adding a new employee or spouse is as simple as getting online and entering in the information. Our broker has zero to do with the process
Posted on 9/10/19 at 9:53 am to Bigfishchoupique
quote:
The broker has Errors and Omissions insurance. Tell him to write a check or make a claim on his insurance to cover whatever medical expense you incur until she is covered
This right here.
Also, get care, pay cash, file claim after. Don't let her suffer. She'll be pissed if she can drink wine with her tennis buddies and you want her unpissed and drinking wine so when she comes home she falls asleep and you get the day to yourself.
Ask HR for a meeting with your broker if this doesn't get fixed but I think it will.
Do you have the ability to print our your elections you did on your navigator. If so, your HR will take care of it with your broker.
If your HR wants a new broker, let me know where you are and I'll get one of our guys to recommend a good one in your area.
Posted on 9/10/19 at 10:00 am to Beessnax
quote:
What is the urgency for her getting care?
I would assume... pregnancy.
Posted on 9/10/19 at 10:04 am to BabyTac
So, as soon as your wife get health insurance coverage, she all of sudden starts having knee pain issues from tennis? This is a huge red flag from insurance co's claims department. Hope you understand that.
Posted on 9/10/19 at 10:14 am to Skin
Doesn't matter if he added her within the proper time frame.
He apparently did what he was supposed to do but the broker didn't do their end of the deal. It happens and should be fixed with not much of an issue.
He apparently did what he was supposed to do but the broker didn't do their end of the deal. It happens and should be fixed with not much of an issue.
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