What to do if my employer has been deducting from my paycheck for health benefits but my benefits have been terminated by the insurance company for nonpayment?

I have pay stubs to prove they have taken the money and a termination letter from the health insurance company with the termination date. I have also received notices that my claims for my pregnant wife have not been paid for both this and last month; I just received the letter from the health insurance company. I am not the only employee who is dealing with this, as I know of one other employee that had received the letter. What can I do to get what is was supposed to be paid for or at least get my money back?

Asked on March 15, 2014 under Employment Labor Law, Pennsylvania

Answers:

M.D., Member, California and New York Bar / FreeAdvice Contributing Attorney

Answered 6 years ago | Contributor

If an employee discovers that their employer failed to provide health insurance after the employee paid their portion of premiums, they have legal recouse against that employer. The employee can do several things. First of all, they can sue for damages in the amount of the premiums paid by them and be entitled to additional damages if they attempted to file a claim with their insurance company while they believed they were receiving coverage and were then were denied. These additional damages can include the cost of any procedures and other expenses, as well as possible punitive penalties. Furthermore, an employer who falsely tells their employee that it is providing coverage when it is not and but who has collected the premiums is committing fraud. In such a case, the employer could face a fine and/or jail time if found guilty of the charge.

At this point, you should consult with a local employment law attorney for further advice.

Anne Brady / Law Office of Anne Brady

Answered 6 years ago | Contributor

Your employer may have been deducting money for your portion and failing to pay his portion.  Or even worse, he was deducting for the full cost and keeping the money for himself, failing to send it on to the insurance.  Your only claim now is against your employer.  You can not force the insurance company to pay claims when premiums were not paid to them.  The employees have a viable claim for fraud against the employer.  They should go as a group to a lawyer, who will send the employer a demand letter on their behalf, and if necessary sue the employer.  Of course, you may lose your jobs, but if this is what has been going on, it is unlikely you would have had jobs much longer anyway.


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