What to do if your employer has not proceeded to add a family member to your insurance policy in a timely fashion?

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What to do if your employer has not proceeded to add a family member to your insurance policy in a timely fashion?

My wife had a baby 2 1/2 months ago. To add our newborn to her insurance at work she needed to be added within 30 days. My wife sent everything to the person in HR that is responsible for enrollment within the 30 days. It has now been over 2 monthsbut our newborn still has not been added to the insurance policy. She attempted to contact the insurance agency, but they state that everything needs to go through her employer’s HR department. We are currently at a stand still and starting to receive medical bills for our child. Is it possible that our daughter won’t be added because it’s been over 30 days even though my wife sent everything she was told that was needed?

Asked on February 27, 2013 under Employment Labor Law, South Carolina

Answers:

SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 8 years ago | Contributor

Yes, it is possible that your child will not be added: the insurer is only required to add family members or otherwise modify coverage if the requests are done in full conformity with the rules as set out in their contract with your employer. That means that if the employer fails to provide its paperwork, information,  etc. in a timely fashion, the insurer does not need to add the child. On the other hand, if the employer, through its negligence (carelessness) causes you to be denied coverage, you could potentially hold the employer liable for all your medical costs which would otherwise have been paid by insurance. It is therefore very much in your employer's interest to get your child added.


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