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Law Educator, Esq.
Law Educator, Esq., Attorney
Category: Legal
Satisfied Customers: 90944
Experience:  JA Mentor -Attorney Labor/employment, corporate, sports law, admiralty/maritime and civil rights law
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I need the health insurance company to reinstate my health insurance.

Customer Question

I need the health insurance company to reinstate my health insurance. I have the money available in my bank now.The premium was due 10/01/13. Thanks for a quick response. xxxxxxx XXX-XXX-XXXXXXX@XXXXXX.XXX

Submitted: 1 year ago.
Category: Legal
Expert:  Law Educator, Esq. replied 1 year ago.
Thank you for your question. I look forward to working with you to try to provide you the information you are seeking for educational purposes.

While I know you "need" to have benefits reinstated, you do understand that all we can provide information about is the actual legality of them canceling your benefits and the process you can use to try to get the company to reinstate your benefits?

I know it was cancelled for non-payment, but is this a COBRA plan? Please explain?
Customer: replied 1 year ago.

Insurance company is Bank of America. It is not a COBRA policy. It is a retirement policy my wife received upon retirement

Expert:  Law Educator, Esq. replied 1 year ago.
Thank you for your response, just a bit more clarification.

Your wife (you) was responsible for making payments for the policy and you failed to make payment on time, have you contacted BoA who administers or provides the benefit?
Customer: replied 1 year ago.

Yes, and they refused to reinstate policy

Expert:  Law Educator, Esq. replied 1 year ago.
Thank you for your response.

These retiree health plans are considered contractual in nature and not mandatory under law. As such the plans are governed under the Employees Retirement Income Security Act, ERISA, which states that in all of these cases the Plan Description governs your contract. This means there is no legally statutory right to reinstatement of the policy, it is contractual, and there is no "grace period" in the laws, but there may be a grace period in the contract and that is where you must begin looking I am afraid (each of these plan descriptions is different and there are thousands of them and I do not have access to them, as I am sure you understand).

If your plan description does not contain a provision about reinstatement/cancellation of the plan, then the only legal right you have remaining is negotiating with the employer's benefits officer and arguing things like you did not receive notice of the bill being due or that they failed to notify you promptly that you would be cancelled and give you an opportunity to cure by making payment. I am afraid though that these are not legal arguments to take to court if they refuse to do so.

Legally the only way you can force them to reinstate your policy would be proving that under the terms of your plan description they did not follow those terms and as such breached the contract with you.



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This is NOT the practice of law nor is it legal advice to you, it is merely educational information for you to use to seek out a licensed attorney in your state to get actual legal advice from them. Please use sites such as http://www.martindale.com or http://www.lexmundi.com or http://www.hg.org to find a local attorney to get actual legal advice in all matters.
Law Educator, Esq., Attorney
Category: Legal
Satisfied Customers: 90944
Experience: JA Mentor -Attorney Labor/employment, corporate, sports law, admiralty/maritime and civil rights law
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