ok, so I was hired in October 2005. On December first, I got wrriten permission for them to start me medical insurance early and it started being withdrawn on my paycheck as of Dec 15. I start accumating bills for medical treatments I was receiving starting on Dec 20.

On April 1, we transfer to a new medical insurance carrier. The old carrier is telling me I was covered until Feb 1 and I proved I was paying since Dec 16. The states that our company has a contract stating they can't start medical insurance until the following pay period after a 90 probation. Obviously, the old insurance company doesn't care to help since our company is no longer with them.

The problem is with CareFirst and my employer. Both are telling me I'm screwed and I have to foot the bill which is several thousand dollars on my own. However, I can't see where this is right since I was technically paying for coverage. Is the employer legally liable since the mistake was on their end and not mine? Any document that states that anywhere for the State of VA??

If I need to clarify anything, let me know. I couldn't find a section dedicated to Insurance questions for employers, so this was the next best spot. :)

Why is your new carrier involved at all? They have no bearing on whether you had coverage previously or not.

If your insurance contact and plan documents do not allow for coverage before the 91st day, then you could not be covered before then. You should have been informed well before now that the claims were not accepted and you shouldn't have gotten an insurance card or been officially enrolled. If premiums were deducted improperly, then you are entitled to a refund of the amount paid. Just taking the deductions from your check does not entitle you to coverage and has nothing to do with whether you are covered or not.

Why is your new carrier involved at all? They have no bearing on whether you had coverage previously or not.

If your insurance contact and plan documents do not allow for coverage before the 91st day, then you could not be covered before then. You should have been informed well before now that the claims were not accepted and you shouldn't have gotten an insurance card or been officially enrolled. If premiums were deducted improperly, then you are entitled to a refund of the amount paid. Just taking the deductions from your check does not entitle you to coverage and has nothing to do with whether you are covered or not.

My new carrier is NOT involved. I'm just saying we switched to a new company. CareFirst was the old provider.

Why is your new carrier involved at all? They have no bearing on whether you had coverage previously or not.

If your insurance contact and plan documents do not allow for coverage before the 91st day, then you could not be covered before then. You should have been informed well before now that the claims were not accepted and you shouldn't have gotten an insurance card or been officially enrolled. If premiums were deducted improperly, then you are entitled to a refund of the amount paid. Just taking the deductions from your check does not entitle you to coverage and has nothing to do with whether you are covered or not.

That's the thing. I was given an insurance card and everything, but now they're denying all the claims prior to my 3 month mark.

My company is offering to pay me how much they would've paid for my coverage to CareFirst which is only 700 or so, now even close to the amount I owe. Should I try to take that or do I have any grounds to argue legally? I even have written documents from my COO and CFO that authroized them to start my coverage early.

You're fortunate they even offered to do that. I'd take them up on it. The employer cannot arbitrarily decide to make an employee eligible under group insurance before the plan document states that the employee would otherwise be eligible. They made a mistake and they're trying to correct it. I'd take the reimbursement and let it go.

You're fortunate they even offered to do that. I'd take them up on it. The employer cannot arbitrarily decide to make an employee eligible under group insurance before the plan document states that the employee would otherwise be eligible. They made a mistake and they're trying to correct it. I'd take the reimbursement and let it go.

That's my whole point. THEY made the mistake and now I'M stuck with 4k+ in medical bills because of it. I would think since it wasn't my fault they made the mistake, they should be fully responsible.

It would be nice of them to offer to foot the bills but they are not legally obligated to do so. They are not even obligated to pay as much as they have offered you. Something is better than nothing, isn't it?

It would be nice of them to offer to foot the bills but they are not legally obligated to do so. They are not even obligated to pay as much as they have offered you. Something is better than nothing, isn't it?

I completely agree. I figured as much, I just wanted to double check to see if there was any legal obligation before I go that route.