Please don't shoot the messenger here, but I bet that in your plan documentation it states that you are required to notify (and typically under ERISA as long as they get that summary plan document out there, they've nsatisfied their notification requirements) ... What might work is getting an attorney to write a cease and desist letter
once per year, and 30 days before any changes is their requirement
Your best case here will a lawsuit (or threat thereof) for something called "Detrimental Reliance," a tort action
You relied on their instructions, and advice that covld haverage was no available ... further that an "REASONABLE PERSON" would have expected no charges or tax liability when coverage was denied
Use of the terms "reasonable person," detrimental reliance," and "I am not a litigeous person but ..." are phrases/terms that will have special meaning to their LEGAL dept.
could be useful in a conversation with (or letter to) them
Let me see if I can find something around reporting them to DOL
Yes, it does say in the benefits book that we are required to notify them of a change in status. However, it also says that Domestic Partners will not be approved without formal application and document submission. After speaking with the benefits rep on the phone about my documents, I was told my partner would not be approved.
When I noticed the tax and called the up about, they said "oh sometimes we approve it anyway"
Honestly I don't think they have a leg to stand on ..... do you have a way to see if there's an EFFECTIVE date on your partner's conerage?
If approved it would have been effective Jan 1 2013.
We tried to use card in ER that day but were unable to. Job contacted me Jan 8th to say DP not eligible for benefits until they get the application and documents...which never happened.
right... I'm just wondering if you can (without showing your hand) find something that would document that they never really added... or only did so after talking to you
What would I be looking for?
is there an online portal where you can check benefits ... or there also have been SOME documentation of coverage such a group coverage certificate ... also ...
can you go back and look at the old paystubs just to be sure it's been there all along?
and finall, if you have no coverage at all, why would it be there now?
The tax has been on paystubs since Jan and they also took money for the benefits in January. In Feb I became ineligible for benefits and they stopped taking fee for health insurance but the the tax is still there
The benefits people are saying they needed separate notification, aside from talking to me about my ending benefits, that DP would no longer be eligible for benefits
rediculous ... I thin a strongly worded letter from an ERISA attorney might be worth a couple of hundred bucks
Also, see this:
So I shouldnt need to sue them. The threat of a suit could be enough to get them to fix this?
I would certainly start there ... again, if you can find an attorney (should be no problem in PA, who is an ERISA attorney) that person can write an intent to file letter or sometimes called a cease and desist letter (with the rationale that your were misled and that they failed to communicate in good faith)
And the threat of filing a complaint through the ERISA enforcement division carries a lot of risk for them as well
If you believe that this may be based on discrimination, you can also threaten them with an employment discrimination suit, (Title VII of the civil rights act)
Ok, thanks for replying. Your answer provided a lot of insight and direction. I appreciate it :)
level one - you ... heightened urgency - attorney writes a cease and desist letter ... higher level, legal action
so, it's going to be level two because theyre not responding to me
You're very welcome ... be proactive on this one... they most certainly have not acted in "good faith."
That's gut as well
[my] intuition as well
Yeah, I'm glad I finally saw the tax. I hope with some pushing theyll take care of it
yes, might be stating the obvious, but talk to "different" people, don't stop with the first person you deal with ... but again that letter carries a lot of weight
Sorry you can rate now....thank you so much!
Should I talk to someone outside of the benefits office?
If you know someone that you can trust, you might try going outside first ... good thought, the higher the better
Also, see this: http://www.superlawyers.com/pennsylvania/Philadelphia/Employee-Benefits-ERISA/browse
So, should future conversations about it just be through a lawyer?
instead of dealing directly with the company who is intent to do nothing
and this .... http://www.lawyers.com/erisa/find-law-firms-by-location/
yes, I WOULD tend to agree that this is how you get thing done these days
alrighty. thanks so much for your help. :)
YW - go get 'em and good luck
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