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Roger, Attorney
Category: Legal
Satisfied Customers: 31672
Experience:  BV Rated by Martindale-Hubbell; SuperLawyer rating by Thompson-Reuters
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My question has to do with the health insurance that I

Customer Question

My question has to do with the health insurance that I receive through my employer.
Open enrollment period of six weeks ended last week and I did not sign up because I assumed that the default scenario was that if I did't want anything to change, then I did not need to do anything. This is how open enrollment worked last year.
During this period my employer sent out four emails reminding people to go to the site. The titles of the email were "Open enrollment begins, ends, etc". The email subject lines never once mentioned the word required, mandatory, urgent....etc. This subject line in the emails contributed to my assumption that I needed to do nothing, and my 2016 insurance would stay the same as my 2015 insurance. I never read any of the eamils, partially due to the email title, and also due the fact that I have been extremely busy and also traveling for business during this time.
I came to work today and was told my company is not going to cover me in 2016 for health insurance because I missed the sign up date.
Is this legal?
Submitted: 1 year ago.
Category: Legal
Expert:  Roger replied 1 year ago.

Hi - my name is ***** ***** I'll be glad to assist.

Generally, you are correct that if you are satisfied with your current benefits and have no new dependents to add, then you do not have to take any action during open enrollment.....instead, your elections for last year will carry over to the 2016 plan year.

However, SOME PLANS DO NOT ROLL OVER, so you must reenroll each year. Apparently, that's what your employer has.

Expert:  Roger replied 1 year ago.

As for what you can do, it all depends on whether your group coverage provides for late enrollment (some do and some don't). If your coverage prohibits late enrollment, you're likely to be out of insurance coverage through your employer for the upcoming year. That said, you could still get private coverage through a local insurance agency......but your employer isn't likely to cover it unless you can convince it to do so.

Expert:  Roger replied 1 year ago.

An employer is required to notify employees of open enrollment, but there isn't much out there to specify if they must tell you that you're required to take action or not based on your coverage......but it would seem reasonable for the employer to do so IF all employees must re-enroll. But, the best thing you can do is contact your claims administrator and see exactly what your employer's coverage is and what options you have going forward.

IF you don't get anywhere, you can contact the US Dept. of Labor and complain about the employer's handling of the open enrollment and see if they can get you any relief or re-open time for enrollment.