Title: Resolving a Persistent Health Insurance Issue: A Case of Employer Non-Compliance and Legal Assistance
In today’s post, I want to share an update regarding a longstanding issue with my former employer’s health insurance plan—a problem that persisted for years and ultimately required legal intervention.
Background:
Several years ago, I left my previous job in 2020, and since then, I have been managing my health coverage primarily through Medicaid. My Medicaid coverage has been continuous, and during that time, I was enrolled in the employer-sponsored health insurance plan as well, which was a secondary coverage. Despite my repeated attempts to have the employer remove me from their insurance plan, they failed to do so and ignored my communications.
Recent Developments:
A few months ago, I received a formal notification from my former employer that my insurance was officially terminated as of approximately six months prior—around fall 2023. The letter also indicated I was eligible for COBRA benefits from that date forward. However, I didn’t receive any proactive notification about this termination or my COBRA eligibility, which is a violation of federal regulations requiring timely notices.
Consequences:
Shortly after this notification, I started receiving notices from healthcare providers indicating that payments made for services rendered had been reclaimed by the insurance company. Many of these bills were from providers who, due to their Medicaid status, couldn’t bill me directly, and many of these claims were now considered overdue and cannot be rebilled to Medicaid. While some of these bills are minor or from large hospitals that can write off unpaid charges without issue, the situation remains inconvenient and unfair for the providers who rely on that income.
Seeking Legal Assistance:
To navigate this complex situation, I reached out to a nonprofit healthcare law organization. Their assessment confirmed that, barring cases of fraud or misconduct, insurance coverage cannot be retroactively canceled. They also made it clear that my employer was non-compliant because they failed to notify me promptly about my COBRA rights upon my separation. Instead, I received a confusing letter six months after the fact, which was effectively useless if I wanted to pursue COBRA coverage.
Legal Action:
The nonprofit law group is now representing me. They are actively working to ensure that my providers are paid for the services they’ve provided and are investigating whether I might be entitled to compensation due to the employer’s regulatory violations. Their support has been invaluable in addressing this ongoing issue, highlighting how crucial it is for employees to be aware of their rights and for employers to adhere to health insurance
