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John
John, Employment Lawyer
Category: Employment Law
Satisfied Customers: 4540
Experience:  Exclusively practice labor and employment law.
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Can I still be covered under my health insurance coverage

Customer Question

can I still be covered under my health insurance coverage after my resignation date of 9/30/15 bec. I was continuing to work in my same capacity after that date? I was still working after 9/30/15 orienting and working with an agency staff person bec. I
needed help coverage. my supervisor was well aware. I got a letter from my health insurance that my last day of coverage was 10/1/15. please advise. I am employed in Alaska, but my contract is with HCRN in Maryland
Submitted: 1 year ago.
Category: Employment Law
Expert:  John replied 1 year ago.

Hi, thanks for submitting your question today.My name is John. I have over 13 years of legal and consulting experience in this area. I’m happy to assist you with your question today.

This is a serious matter. I think what occurred is that you declared intent to resign and they informed their insurer of that date, but you then worked beyond that date. An employer cannot cancel health insurance before your last date of employment - you are still covered by that plan until you are no longer employed. The employer's failure to submit premium payments to the health insurance carrier is a violation of law called the Employee Retirement Income Security Act (ERISA). Under this statute the employer has a fiduciary duty to pay premiums as they become due and ensure coverage does not lapse.

I believe this answers your question. However, if you need clarification or have follow-up questions regarding this matter, I will be happy to continue our conversation – simply reply to this answer. If you are otherwise satisfied with my response, please leave a positive rating as it is the only way I am able to get credit for my answers. Thank you, ***** ***** wish you all the best with this matter.

Customer: replied 1 year ago.
I had already spoken to human resources. My last official day is 10/20/15 this is the date I gave human resources since the date of 9/30/15. I gave this to them in writing. I already spoke with them that I was still working and needed to have my health insurance covered till 10/20/15. They would not change it. The human resources person asked me what dates I saw a health care provider , I gave them to her, but now I still would like to get my eye glasses prescription covered for new glasses before 10/20/15What should I say to my employer human resources so I can still have health insurance coverage up till 10/20/15...I am afraid that they will not take me seriouslyI saw some health care providers after the 10/1/15 date and when I went to call my health insurance the past Friday to try to get eye glasses coverage for new glasses they said I no longer had coverage and I needed to call my employer
Expert:  John replied 1 year ago.

Ask them a) for a copy of the full plan description including who is a qualified participant in the healthcare plan, and b) after reviewing that you should find that if you work x hours per week/month you are a qualified participant. They cannot deny you coverage because you gave them an earlier date than you actually resigned. If all else fails get the department of labor involved which you can do here: http://www.dol.gov/ebsa/contactEBSA/consumerassistance.html

Customer: replied 1 year ago.
I worked fulltime 40hours/week. I have one other question, since my last day is 10/20/15, I took 10/16, 10/19 and 10/20 I as PTO which I had enough PTO coverage for.By Law I still have coverage till 10/20/15, I want to get my health insurance to pay for my prescription glasses that I want to get filled tomorrow. When they call the insurance company they will say I am not covered. Should I just pay out of pocket then have the insurance company reimburse me? I am afraid that my company will not tell them in time or it might take too long
Customer: replied 1 year ago.
What do you advise I say to them?
Expert:  John replied 1 year ago.

At least have them attempt to make the claim for the glasses. If it gets rejected then pay out of pocket...keep all reciepts, so you can later have the claim made retroactively to that date.

Expert:  John replied 1 year ago.

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