Employer dropping dependents from Health Coverage

[Guest DNichols]

I was dropped off my husbands health insurnace...we live apart but are not divorced. His employer told him I had to be taken off because we were not living together. I did not find this out until I went to Kaiser to refill a high blood pressure medication and was turned away. Consequently, I had a heart attack caused by not having the medication. I am still trying to get the employer to reinstate my health insurance. Is there any FED agency or someone that can order them to do so? HELP!:mad:

[KIP KRAUS]

From my experience I don’t understand the rational. Most eligibility provisions for spousal coverage as a dependent typically requires that they be legally married. I can’t imagine that Kaiser has an eligibility requirement that a legal spouse must reside with the employee in order to have dependent coverage. I would contact the state insurance department of the state in which the employer has been issued the medical contract with Kaiser.

You may also want to contact the US Department of Labor.

[Guest Therese]

Has the employer told you directly why they dropped you? Did your husband show you a letter from them explaining why you were dropped? If not I would ask the employer. There may be a misunderstanding here somewhere. Most employers would inform you in writing that you were being dropped and why.

[jeanine]

Were you offered COBRA?

[Guest DNichols]

I was told by the employer that there is nothing they can do for me, because it is no longer an open enrollment period. My husband is on my side and tried to get me put back on the policy. The HR lady admitted that she told my husband I had to be taken off, but the big wigs in the company are lieing and telling my attorney that my husband took me off....stating that we were divorced. But to this day we still are not divorced or legally separated. I called the DOL in Oregon they reffered me to Fed benefit and welfare dept., they reffered me back to the Oregon DOL.....which in turn now reffered me to the insurance commission....and so on...I just need some health coverage so I can have my heart and blood pressure medication. I haven't alot of funds.....I guess I need an attorney in my area to help me, take my case on a contingency or is willing to go after the employer for attorney fees. Thanks so much.

About being offered COBRA? The employer sent my husband a letter regarding COBRA 30 days after I was ineligible to aquire the benefits. To me, if the employer was so worried about us living apart (their grounds to cancel the insurance) why the hell did they send the COBRA letter to my husbands address, when in fact they had my address.....2 blocks away from my husbands. The attorney I have does not have any experience in this sort of field in his law practice.

[KIP KRAUS]

Read this article on

www.ebia.com/weekly/questions/2002/COBRA020912.html

[Guest DNichols]

But the whole point is that I am not divorced or legally separated now. They cancelled me almost 2 years ago, and I have been fighting with them ever sense to get back on the policy. Especially now when I need the heart medication and am very broke. I feel as tho the employers mistake caused my heart attack because I went without the medication I needed. Thanks so much for your help.

[KIP KRAUS]

You need to get an attorney that will pursue the employer.

The employer may have allowed a change in plan status on the basis of your husband telling them that you were divorced.

Two years is a long time. Get an attorney.

[Guest Therese]

Two years? Haven't there been two enrollment periods since then (or at least one)? Has the company prevented your husband from re-enrolling you during open enrollment? It does sound like you need an attorney who works with employee benefit plans.

[Guest DNichols]

Does anybody know a good attorney in the Oregon and Washington area. I have emailed and phoned several, but they all want thousands of dollars in retainer fees.

Both Kaiser and the employer Rockwood Water seem to be hiding their heads in the sand......neither wanted to take the blame.....all I am interested in now is affordable health insurance so I can get what I need to stay healthy. Which right now...I need a cardiology opinion. The health dept Dr. told me I needed a pace maker, but tht agency is very limited on quailifed Dr.s.

Thanks for any help.....

[maverick]

Kip got it right the first time. This is an issue for the State Insurance Commissioner. If Oregon is anything like Wisconsin, I would expect them to take immediate action. Unfortunately, a lot of time has passed, so retaining an attorney may be the only way to get coveage reinstated retroactive to when you were dropped from the health plan.

Maverick

[Guest Therese]

Have you asked when the next open enrollment period is? I assume now that the employer knows you are not divorced they would allow you in during open enrollment if your husband signs you up. Many plans have enrollment in the last quarter of the calendar year so I would ask about this now. You would still have an issue probably requiring an attorney about past coverage (and possible disputes about pre-existing conditions depending on the type of plan), but at least you'd have some coverage going forward.