Does a Health Insurance Company by law have to notify a client when their medical coverage is terminated?

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Does a Health Insurance Company by law have to notify a client when their medical coverage is terminated?

We were enrolled in Aetna through my husband’s company last April. In August we received the Book of benefits and a package of forms INSIDE to sign up again in October, their Open Enrollment date or sign a waiver to deny the coverage. We didn’t see the forms, never signed a waiver, thinking we were covered. In January new cards arrived, one with PPO on the top and the other with DENTAL. We assumed one was medical and one was dental. Reality, We have no medical insurance and can’t get any until October w company. No notification from our employer/Insurance Co telling us we have no insur

Asked on June 17, 2009 under Insurance Law, Ohio

Answers:

L.M., Member, California Bar / FreeAdvice Contributing Attorney

Answered 5 years ago | Contributor

Not sure what happened here.  If they sent you cards, they must also have assumed you were still covered.  Typically when open enrollment comes around, you use the forms to either change your coverage or to waive it.  If you want to leave it in place, you do nothing.  I would contact the employer and Aetna, both in writing, and tell them what you told me, but in greater detail.  Send a cc to the Ohio Dept. of Insurance at https://insurance.ohio.gov/ and enlist their help.  Hopefully they will reinstate your coverage.  If not, you may need to get some assistance from a local attorney who is well versed in health insurance and employment issues.


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