Legal question about health care...

[toekramp]

First I realize my sister needs to seek professional legal advice, just hoping you guys can point her in a more specific direction.

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My sister had been working as a travel nurse for a couple months here in Denver and decided to go snowboarding about 6 weeks ago. Long story short, she broke her wrist first run and I took her to the hospital. On the way to the hospital, she called her recruiter/travel nurse contact and made sure that her health insurance had been activated and that she'd be covered. They confirmed she was good to go.

Now since she's a nurse, the company told her she couldn't come back to work until her wrist was better (which takes about 6 weeks) and they don't provide short term disability. So she went job hunting and found another position. All the while she is told that she is covered by her health insurance for 30 days from the time she quits.

Yesterday she gets a bill in the mail for $1700 for the emergency room visit. She calls her previous employer who informs her that since she quit, they back dated her health insurance to the last day she worked (not the day she quit). And that she is responsible for the emergency room visit and all subsequent doctors visits. She is mad to say the least and has spent a great deal of time on the phone arguing. Who should she be speaking with at this point
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Cliffs:
Sister broke her wrist
Company says she can't work while injured
Cancels health insurance and back dates it so she has to pay for everything

 

[spidey07]

Why did she quit? When she did she forfeited all benefits from her last day she showed up for work. Sounds like the employer is in the right here.

You should be speaking with the insurance company and the previous employer, but I don't see how or why your sister expects health insurance when she isn't working.

 

[MrChad]

If she was laid off, I might be able to see some extension of benefits past the date of her termination. But in this case she quit, so she may be out of luck.

 

[her209]

Check the Department of Labor website
http://www.dol.gov/ebsa/faqs/faq_consumer_cobra.HTML

 

[toekramp]

Originally posted by: spidey07
Why did she quit? When she did she forfeited all benefits from her last day she showed up for work. Sounds like the employer is in the right here.

You should be speaking with the insurance company and the previous employer, but I don't see how or why your sister expects health insurance when she isn't working.

She quit because she was going to be unable to work for 6 weeks. And her last day of work started on the 13th and ended on the 14th (she worked evenings). The injury happened on the 14th, as did the emergency room visit. At the very least they should be covering that.

edit: and once again, her employer stated on multiple occasions that her health insurance would be good 30 days from the time she quit.

 

[darkxshade]

Originally posted by: MrChad
If she was laid off, I might be able to see some extension of benefits past the date of her termination. But in this case she quit, so she may be out of luck.

Unless of course she included a pic on her insurance claim in which case a bill might have been avoided... just sayin.

 

[rasczak]

well wait a minute here, first off, did you even pay for her insurance, or was that covered 100% by her employer?

if she paid for her insurance, then she was covered until the last date she was paid through.

if her employer covered her 100% then she may have no claim. but your best advice at this point is to have your sister call the insurance company and figure it all out with them.

the biggest issue I have with this is who has been paying the premiums.

 

[dougp]

Originally posted by: spidey07
Why did she quit? When she did she forfeited all benefits from her last day she showed up for work. Sounds like the employer is in the right here.

You should be speaking with the insurance company and the previous employer, but I don't see how or why your sister expects health insurance when she isn't working.

If she was still employed while the visit to the ER happened, then no, her employer is in the wrong. Basically they'd be removing her coverage while she still worked there since coverage begins or ends on the first of every month.

 

[SacrosanctFiend]

Check her health insurance policy. If it has a provision for retroactive terminations, then it is not illegal for the company to do so. She should be able to pay for COBRA coverage for that month pending the company she worked for was large enough to be covered under COBRA (20 employees or more).

 

[SacrosanctFiend]

Originally posted by: dougp

Originally posted by: spidey07
Why did she quit? When she did she forfeited all benefits from her last day she showed up for work. Sounds like the employer is in the right here.

You should be speaking with the insurance company and the previous employer, but I don't see how or why your sister expects health insurance when she isn't working.

If she was still employed while the visit to the ER happened, then no, her employer is in the wrong. Basically they'd be removing her coverage while she still worked there since coverage begins or ends on the first of every month.

If her policy allows for retroactive terminations of coverage, the employer did nothing wrong.

Not only that, an employer is allowed to revoke coverage of an active employee in certain circumstances (i.e. the employee falls under the required amount of hours worked for coverage.)

 

[compman25]

And usually when you work a shift that starts on one day and ends the next day, the way it is counted is as the day you started, not the day it ended. So she may have worked on the 14th, but her last day working was the 13th.