section 125 cafeteria plan

[Guest bigsky]

I am a nine-year school district employee that participates in a section 125 cafeteria health plan. This year was the first time enrollment was done "on-line." I apparently did not click the correct box to have my two boys insured (who have been insured w/ same plan all their lives.) I did enter all their info. (ss#, birthdate) and I even have a printed copy of this w/ an approval date for both boys. The benefits administrator at the District told me that the approval date was only verifying their personal information, not that they were approved for insurance. And, of course, I was told that I'd have to wait for next May and open enrollment. Unfortunately, both boys have asthma and severe food allergies, so no other carrier will pick them up. My arguments that my intent was certainly to cover them and if this was my fault it was a clerical error have fallen upon deaf ears.

Do I have a chance if I continue to fight this?

[papogi]

Depends on your specific paperwork, and the wording contained therein (i.e., was everything explained). If your plan sent out printed confirmation of benefit forms showing your elections and giving a week or two to change the benefits if you notice anything wrong, you might not have much luck getting the election changed. If your plan did not send confirms, and instead only relied on each employee printing out the confirm from their web browser, you might have a case, but, again, it depends on the explanations/disclaimers contained on your documents. Courts have almost always ruled in favor of employees rather than employers in situations which are ruled "unclear."