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Marsha411JD
Marsha411JD, Lawyer
Category: Employment Law
Satisfied Customers: 19770
Experience:  Licensed Attorney with 29 yrs. exp in Employment Law
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I filled out my open enrollment back in December and thought

Customer Question

I filled out my open enrollment back in December and thought I included my wife but somehow she was not I have worked for cardinal glass for 17 years and they tell me that there is nothing they can do and then I called blue link and they told me they cant do anything it would have to be done through my employer my wife has copd and severe emphysema which requires her to be on oxygen 24/7 plus 5 medicines so I'm at a stand still don't know which way to turn I think if I had missed to put my wife on my insurance a red flag should of popped up and it should of raised certain questions what do I do thank you al
Submitted: 10 months ago.
Category: Employment Law
Customer: replied 10 months ago.
Posted by JustAnswer at customer's request) Hello. I would like to request the following Expert Service(s) from you: Live Phone Call. Let me know if you need more information, or send me the service offer(s) so we can proceed.
Expert:  Marsha411JD replied 10 months ago.

Hello,

Thank you for the information and your question. Unfortunately, the employer and plan administrator are right. Since I assume this was not an issue of a new marriage in the middle of a plan year, in which case you could have enrolled her mid-year after you were married, the only time the law allows for adding her is during open enrollment. That is an absolute rule of the law. An employer and plan administrator would violate the law ERISA and tax laws by allowing enrollment outside of open enrollment in this case.

Also, although the employer could have a system to alert employees that they have left off a family member, they are under no legal duty to do that for an employee. The responsibility lies only on the employee to enroll their eligible family members during enrollment periods.

As for an alternative since your wife is apparently not covered under other insurance, it sounds like she may qualify for SSDI (if she has had enough employment credits) or SSI if not, and that, in turn, could qualify her for Medicaid, depending on the household income, in the short term and after 2 years on SSDI she would qualify for Medicare. Otherwise, she will need to find insurance coverage through the Affordable Care Act (ACA otherwise known as Obamacare). If she needs help enrolling and finding the best plan for her situation, there are usually local organizations that assist with that process. Otherwise, she can do her search online. Finally, if you all cannot afford coverage, and qualify, she may be able to receive some free health care assistance through the local public health care clinic.

Please feel free to ask for clarification if needed. If none is needed, then if you could take a moment to leave a positive rating in the box above, I will receive credit for assisting you today. Thank you.

Expert:  Marsha411JD replied 10 months ago.

Hello again,

I wanted to touch base with you and make sure that you did not have any follow up questions for me from the answer I provided to you on the 12th. For some reason, the Experts are not always getting replies or ratings (at the top of the question/answer page you are viewing or in the pop up box for this question), which is how we get credit(paid by the Site) for our work, that the customer thinks have gone through. In your case I received neither. If you are having technical difficulties with reading, replying or rating, please let me know so that I can inform the Site administrator. Please note that Site use works best while using a computer and using either Google Chrome or Firefox.

In any event, it was a pleasure assisting you and I would be glad to attempt to assist you further on this issue, or a new legal issue, if needed. You can bookmark my page at: http://www.justanswer.com/law/expert-marsha411jd/

Thank you.