My question involves labor and employment law for the state of: NC
Over last two years, my current employer has offered 4 health insurance options (plans are self-insured or self-funded) - Plan A (monthly employee contribution $0), Plan B ($70), Plan C ($80), Plan D ($150). Plan C is Plan B + hospital indemnity insurance from colonial life. I was offered Plan A, B, C & D for 2017 & Plan A, B, & D for 2018. I signed up for Plan C for 2017 & Plan D for 2018. Both years my employer deducted $80/month (for Plan C) but mistakenly enrolled me in Plan A. During this time, insurance administrator rejected insurance claim (as it was not covered by Plan A but covered by Plan C & Plan D). Also, I paid in cash (without insurance) for other health services as those services were not covered by Plan A.
Recently, I found out about possible mistake & informed my employer. Without my consent, over my objection & without advance notice, my employer has retroactively 1) cancelled my coverage from Plan A & 2) enrolled me in Plan B backdating it to 1/1/18. I haven't informed them about 2017 as I'm waiting for documentation (for proof) from insurance administrator. I want employee contribution refunded & prospectively enrolled in Plan D or Plan B (as entire required employee contribution was not deducted for Plan D).
Rescissions are prohibited (except for fraud and intentional misrepresentation of facts) under the Affordable Care Act by federal regulation 45 CFR 147.128: Rules Regarding Rescissions. https://www.law.cornell.edu/cfr/text/45/147.128 As per my understanding, my employer cannot retroactively cancel my Plan A coverage. As a result, they cannot retroactively enroll me in Plan B & must refund employee contribution.
Is my employer allowed to retroactively cancel my coverage & enroll me in different plan?
Is my understanding regarding this matter correct?
What recourse do I have?
Over last two years, my current employer has offered 4 health insurance options (plans are self-insured or self-funded) - Plan A (monthly employee contribution $0), Plan B ($70), Plan C ($80), Plan D ($150). Plan C is Plan B + hospital indemnity insurance from colonial life. I was offered Plan A, B, C & D for 2017 & Plan A, B, & D for 2018. I signed up for Plan C for 2017 & Plan D for 2018. Both years my employer deducted $80/month (for Plan C) but mistakenly enrolled me in Plan A. During this time, insurance administrator rejected insurance claim (as it was not covered by Plan A but covered by Plan C & Plan D). Also, I paid in cash (without insurance) for other health services as those services were not covered by Plan A.
Recently, I found out about possible mistake & informed my employer. Without my consent, over my objection & without advance notice, my employer has retroactively 1) cancelled my coverage from Plan A & 2) enrolled me in Plan B backdating it to 1/1/18. I haven't informed them about 2017 as I'm waiting for documentation (for proof) from insurance administrator. I want employee contribution refunded & prospectively enrolled in Plan D or Plan B (as entire required employee contribution was not deducted for Plan D).
Rescissions are prohibited (except for fraud and intentional misrepresentation of facts) under the Affordable Care Act by federal regulation 45 CFR 147.128: Rules Regarding Rescissions. https://www.law.cornell.edu/cfr/text/45/147.128 As per my understanding, my employer cannot retroactively cancel my Plan A coverage. As a result, they cannot retroactively enroll me in Plan B & must refund employee contribution.
Is my employer allowed to retroactively cancel my coverage & enroll me in different plan?
Is my understanding regarding this matter correct?
What recourse do I have?
Job Benefits Wrong Health Insurance
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