| If your employer automatically deducts money from your paycheck for health insurance,
chances are you don't even know whether that money is, in fact, getting
passed along to your health insurer. And why should you? You trust your
employer to pay the premiums.
But let's
say that one day you get a notice stating your health plan has rejected
your claim because the policy was canceled for nonpayment of premiums.
"This
happens all too often," warns a brochure from the Ohio Department of
Insurance. Under Ohio law, the insurance company is in no way at fault
in this situation; your employer is. By law, the plan must notify your
employer that its health plan is being canceled. In turn, your employer
must then notify you of the cancellation within five business days.
Failure to do so is a felony. But if your employer doesn't notify you
that your coverage has been canceled, there's little even a state
insurance department can do to get your premiums back, your claims paid
or your policy reinstated, which means you could be stuck footing some
rather hefty medical bills. However, you can start legal proceedings
against your employer if need be.
|
Some states have health plan continuation and conversion laws that
allow you to maintain coverage even when your plan is terminated. |
The
situation is similar in Florida. According to the Florida Department of
Insurance, your insurer is not required to provide you with updates
about the premium status for group health plans that are (supposedly)
being paid by your employer. However, once your health plan has been
canceled, the insurer then has 45 days to notify you, as well as your
employer. "The contract is between the policyholder (the employer) and
the insurance company," the insurance department notes. "The insurance
company would not be liable for your claim since the premiums have not
been paid."
Meaning: Again, you would be stuck with the medical bills.
Still, there is a modicum of protection.
Some
states have health plan continuation and conversion laws that allow you
to maintain coverage even when your plan is terminated, including
Florida. Florida law gives you 63 days (from the
date you are notified either by your health plan or your employer that
your coverage has been canceled) to convert the former group policy to
an individual health plan. And a word of hope: That conversion policy
might include payment of any outstanding medical claims under your
employer's old policy. In Kansas, if your group policy is cancelled for any reason,
including nonpayment of premiums, you are allowed to continue your
exact same benefits for up to six months — however, it's at your own
expense; you must pay the premiums yourself. The Kansas Continuation
Law puts the burden on the insurer, not the employer, to give you
notice about your continuation rights. |
