Altered enrollment forms!!!!!!!!!


Recently, my company completed its open enrollment. We did not change our medical coverage, but did change the company providing our LTD, STD, and Life.
Each employees original enrollment form was kept with me, and a copy was sent to the new company. Yesterday, the copies were sent back from the company, to be distributed with a confirmation of benefits notice. One employee had elected not to answer the gatekeeper question, so as not to require her spouse be subject to Evidence of Insurability. If the question is left blank, the coverage is issued, but at ½ the requested amount.
After reviewing her enrollment form copy, she was stunned to notice that not only had the gatekeeper question been answered, but it was incorrect. I compared the original on file with the copy returned to the ee, and it was clearly altered after it left my possession. I am concerned now of the validity of any information I am to forward from the employee from this company, and concerned for any liability regarding the violation of privacy now that the ee is required to discuss this situation, instead of being allowed to leave it blank as was her original intention. Any thoughts?

Comments

  • 4 Comments sorted by Votes Date Added
  • I would be having a conversation with my contact at the company I sent the enrollment form to. They may have internal issues that they need to resolve. You certainly have an issue that you need to resolve.
  • Do you have a broker that you are going through? If so, I would pick up the phone and call him/her and have them investigate. If not, are there any initials or signatures from someone who might have processed the form? I would definitely have a conversation with the company representative to find out what happened. You might ask them for a copy of what they sent each employee so you can compare to see if there is a real problem or if this is an isolated incident. Did they give the employee full benefits or did they still give them benefits at 1/2 the rate? If they gave them what they wanted, why do they need to discuss anything about her situation. She doesn't have to answer any questions she doesn't want to. Can she fill out a new application? Good luck.


  • Matters of this nature are required to be brought to the attention of upper management. I called the broker, who gave me a "gee, I don't know what happened" song and dance. The spouse was covered at 100%, based on someone other than the ee filling out that one question on the application. Apparently, the spouse has an illness, and the question was left blank on purpose. He is still enttilted to the 1/2, but the employee is angry that this had to be discussed in any fashion with management. HIPAA you know.
  • I would be calling the broker back and demand they find out who made the alteration. This is a falsification of information and the employee has every right to be upset. The broker we use would be getting to the bottom of this issue or we would be getting a new broker!
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