I lost health insurance because employer lied about size of org. Told Feb. 22 that coverage had ended Jan 1. Do I have recourse?

Asked over 1 year ago - New York, NY

Employer apparently tried to get lower rate on insurance by inflating number of employees covered. Insurance is in my employment agreement/contract, but I wasn't told until February 22nd that coverage was suspended from Jan 1. Coverage has since been reinstated as of Mar 15 but it passed the 63 days "pre-existing" date and I'm worried I may run into problems. I'm also angry more generally about the mismanagement inherent in this.

Attorney answers (2)

  1. Russell E. Adler

    Contributor Level 11

    Answered . Sounds there may be an ERISA violation -- not my specific practice area, but you should contact federal Department of Labor (www.dol.gov), the agency that enforces ERISA.

  2. Richard D Carter

    Contributor Level 5

    Answered . Since it is part of your employment conditions, even if the insurance company is off the hook the employer, as Plan Sponsor and the individuals who screwed up are on the hook for any costs that accrue to you. I doubt that this would be considered a break in coverage but the insurer could try. If that happened the employer would be liable for your care. See what happens in the next few months to you or your co-workers. Also make a WRITTEN request for coverage docs with dates of coverage. If there are any problems after that, contact an attorney who is experienced in ERISA.

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