Medical Plan Benefit Coverage Change

[Guest Tricia Kennedy]

We are making a last minute change to the infertility coverage of our national medical plans effective 1/1/2008 (our Open Enrollment is already in process). The coverage will now have a $10,000 maximum lifetime limit (currently we have no dollar limit). Do we have a legal obligation to inform our employees in advance of Open Enrollment of this change? (We will not be allowing employees to make 2008 election changes after the Open Enrollment period).

[leevena]

I cannot say with any confidence whether you have a legal requirement, but I suspect you do. Legal issue aside, I would recommend that you notify everyone about this change. To begin with, this sounds like "bait and switch" for the employee who enrolled already believing unlimited benefit. Secondly, what does this say about the integrity of your company and the staff involved with the enrollment. And lastly, why in the world would you not want to give everyone the correct information?

[MARYMM]

We are making a last minute change to the infertility coverage of our national medical plans effective 1/1/2008 (our Open Enrollment is already in process). The coverage will now have a $10,000 maximum lifetime limit (currently we have no dollar limit). Do we have a legal obligation to inform our employees in advance of Open Enrollment of this change? (We will not be allowing employees to make 2008 election changes after the Open Enrollment period).

I haven't done Benefits Admin. for almost 2 years but I remember that there was a requirement to notify ee's 15 days in advance of any changes to medical benefits. I'm not sure if it was a State (CT) or Federal requirement, however.