Jump to content

Who pays?


Benefits 101
 Share

Recommended Posts

Company X changed health insurance carriers on 1/1/11. They did not send in a termination notice until 2/15/11...so from 1/1 to 2/15 they had 2 insurance companies. Old insurance A, and new insurance B. The old insurance termination date that was requested was 1/1/11. However, insurance company A terminated the insurance on 3/1/11 saying the termination letter was not sent in a timely manner.

Some employees used the old insurance cards claims were made with insurance A. Insurance B is willing to pay these claims...but the claims have been marked as paid.

Insurance A will NOT subrogate the claims.

So, Company X is left in collections for 2 months of unpaid premiums to Insurance A.

Anything they can do? State of PA.

Link to comment
Share on other sites

Company X changed health insurance carriers on 1/1/11. They did not send in a termination notice until 2/15/11...so from 1/1 to 2/15 they had 2 insurance companies. Old insurance A, and new insurance B. The old insurance termination date that was requested was 1/1/11. However, insurance company A terminated the insurance on 3/1/11 saying the termination letter was not sent in a timely manner.

Some employees used the old insurance cards claims were made with insurance A. Insurance B is willing to pay these claims...but the claims have been marked as paid.

Insurance A will NOT subrogate the claims.

So, Company X is left in collections for 2 months of unpaid premiums to Insurance A.

Anything they can do? State of PA.

This is a contract problem due to the failure of company A to provide notice of termination of the contract to Insurance A. Absent any provision in the contract that would invalidate the contract with A (e.g., entering into a contract with another insurer at the same time as the contract with A is in effect), X is liable to Insurance A for Jan and Feb premiums. See if Co B would give a partial rebate for Jan and Feb since Co A is paying some claims incurred in those months.

mjb

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
 Share

×
×
  • Create New...