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Stuck in limbo


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Please help, I'm not knowledgeable about insurance rules and my employer's benefits department isn't very communicative.

My wife and I were married December 28th. We were both covered by our respective employers. February 9th we decided to put myself and my dependants on her health plan, within the 60 day window allowed by her company. Her company backdated coverage to January 1st. March 10th, I tried to cancel my health insurance, assuming the life event window would run from the day we made the change. My company will not stop payroll deductions because the effective date of the change automatically put me outside of the 30 day window.

My case is in "appeal" and I'm still having $85.00 deducted weekly for insurance that I don't need, can't use, and can't afford.

Is there anything constructive I can do to get my money back? Do I have any legal recourse? Where can I find the specific federal regulations that are supposedly forcing me to carry this burden?

Thanks in advance for your help

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Does not look good, but I do not have all the info.

If you are covered under a medical plan, without a Section 125 premium conversion (pre-tax) then you can cancel your medical plan at anytime. Deductions would end when appropriate. However, if you are covered under a Section 125 premium conversion plan, things are different.

If you are covered under the 125 plan, as a general rule, your election(s) are irrevocable for the plan year (see the plan docs if you do not know your plan year). Employers are not required (aside from HIPAA special enrollment rights) to allow for off anniversary changes, but many/most do. You should have received a copy of the plan documents, please review and see what you find.

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Your main issue is that her employer backdated the coverage to January 1st, so that is when you had other coverage and your change in status date (marriage) was 12/28. So neither of those dates will allow you to wait until March 10th under Section 125 qualifying events.and the time period allowed.

You do need to ask for that section of the plan document/summary plan description to see what the plan allows. Not all plans allow for the same thing.

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