Did the HR Dept. meet its obligation?
lwl
11 Posts
In Virginia, does a FTE have to sign a waiver stating that he/she does not want to participate in an organization's health insurance coverage, or can the employer assume that the employee does not want coverage if they have not responded to the HR Department one day after the open enrollment period closes? Case in point is that an employee who works in the field and has limited in-office time failed to turn in her application for insurance; she has worked at the agency for 16 years and has had coverage each year. Since the HR department had not recieved the employee's application, they sent an email saying that since they had not heard from the employee, that they "assumed" that she did not want coverage and therefore denied her request to turn the application in 2 days late. There was no attempt to contact her by cell or office voice mail.
Any feedback?
Any feedback?
Comments
Additional members helps the over all premium expense of the plan; however, the expense of claims burdens the employees who are also a participant in the claims expense of every other members claims.
Bottom line there is a published deadline stick to it for everyone to include every EXEMPT member of the plan.
PORK
We are a fairly small company compared to lots of you - 68 EEs, some of whom are part time. We utilize a customer service approach with the EEs being our customers. In cases like these, we strive for service above and beyond the letter of the law - and would have contacted the EE ahead of time.
We have several remote EEs - and have had frequent occurrences of lost mail, including paychecks. So we watch for this sort of thing and had the circumstances described happened at our shop, I have no doubt we would have contacted the EE before the deadline to make sure we knew his/her intent with respect to insurance.
We have also had situations when enrollments missed the deadline. We were able to work with the carrier to get these people on the insurance. We have made mistakes, EEs have made mistakes - we try to end up doing the right thing.
In this case, we would have accepted the late enrollment and gotten this 16 YEAR EE covered.
lwl -- are you a member of the HR Department in question?
Good Luck!
I am interested in opinions, not retalliation.
Knowing this ee has had coverage for 16 yrs I would give them the benefit and extend for the 2 days.
Were you changing carriers?
Normally if there are no changes to be made the ee would have to do nothing unless she decides to waive the coverage, add/change dependents or change plans.
It cuts down on later claims of "You did not tell me that was available."
Now, let me turn the tables. Every open enrollment that I have ever been a part of, and specifically those under my direct supervision, have always been at least 30 days in duration. We usually begin the communication process at least 30 days prior.
We currently have approximately 15 regional and national account managers who are based out of their home offices. Guess what? Each and every one of them makes open enrollment. Sometimes all we get is a fax or Fedex, but we get it done. Surely, your wife did not find out about this the day prior to open enrollment ending. Shame on her for procrastinating. She needs to shoulder some of the responsibility here.
Gene
But, I am the original objector to non-HR people getting on The Forum trying to build cases or prove employers wrong or set something straight for personal reasons. It's horsesh*t that you're not doing that, although you suggest your exercise is not personally motivated, but somehow for the greater common good and a simple exercise in harmless research. As was said earlier, neither you nor we have knowledge of the company's certain practices or what they did or when they did it or what your wife did or did not ignore or what manner of mailouts and notifications were sent.
And, enough of this about what you would have done had you been in the HR Department. Since you have not worked in HR and do not work in HR and are not involved in the mechanics of such things as open enrollments, it's rather vacuous for you to say what you would have done. Sort of like me saying what I would do if I were in charge of accounting or if I were a jockey in The Preakness. Simply, employees have responsibilities and HR too often is expected to hold everybody's hand, accompany them to the restroom, make their decisions for them and manage their personal business for them...and take a beating when an employee fails in their personal responsibility.
I see: your wife for the last 16 years has been covered by your medical program and she continues today to be covered by your medical plan.
I see: your medical plan has now changed it's benefit plan to effect a higher cost of premium payment or deductibles.
I see: these cost made you and your spouse realize that her company medical benefit plan, as a single employee, would be cheaper for your personal interest.
I see: your spouse then remembered the open season is on going right now "low and behold" the open season ended two days ago, and now your spouse trys to push the responsibility off on the HR and/or benefit manager for your personal mess-up. You would prefer the employees of her company suffer the claims participation rather than your plan participants.
Good luck, I hope you and your spouse remain healthy all year. Open season does come around ever year so mark your calendar for May of 2006.
PORK
Secondly and most importantly, I was sincere in my statement that I was interested in opinions, not retalliation. As a matter of fact, this whole issue has been resolved. While I watched from the sidelines and this posting has been active, my wife wrote a letter to her employer explaining her situation and requesting a reconsideration of the decision. The agency did indeed do this and decided to reinstate her coverage, with an apology from management after realizing that there were legitimate extenuating circumstances. In addition, I was able to drop her from my plan becasue my enrollment period just ended yesterday.
I have enjoyed and I appreciate the feedback and the variety of responses. It is clear that are as many opinions as there are HR Managers. I understand some of the skepticism and frustration that I read in the postings because I work for a small employer and one of the hats that I wear deals with HR issues. It is also difficult to get the complete picture of what is going on in a situation through a medium such as this. One posting stated that he/she had objections to non-HR folks being on the forum, but there are those of us who are responsible for various duties and therefore get information from many sources as possible.
Paragraph two. You were interested in opinions; not retaliation. Neither. You did your research and our comments helped your wife write the letter. Glad we could help. We are, after all, the employee advocates.
Three: if you were wearing your HR hat, none of us would have a problem. You were wearing the employee hat and looking for a flaw in the way HR handled her coverage so that you could act on it and get her enrolled. At least now when you wear that HR hat, you'll have this thread to help you out.
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