Our company pays the premium for an employee and his family. His family’s premium will no longer be paid by the company. How much of a notice must be given to the employee before the company no longer pays for his family’s coverage?


Answer

Employers must give employees at least a 30 day notice prior to recession of a health plan and a 60 day notice for material benefit changes. In other words if a plan is cancelled for any reason it's 30 days, if the plan is going to change benefit-wise it's 60 days. The date of the recession triggers a 60 day special enrollment window for the employee to enroll in a Marketplace health plan, but they can use the prior 30 day notice to shop for plans and get the enrollment in place.

Learn more from BCBS, they did a nice job laying out how the law affects this.

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Joe on


Answer Rating:

What sort of action can you take against an employer who does not give 30 days notice of cancellation of a policy?

Emily on


Answer Rating:

Does this 30 day notice count for employers in the State of Wisconsin who have less than 20 employees?

ObamaCareFacts.com on

I believe the 30 day notice counts for all employers and insurers. It’s a federal, not state law.

Jill on

Does this law also pertain to Cobra? I discovered 15 days into a month that my cobra ended the prior month end, even though I was paid to date. Further, I can’t seem to get a refund from ADP…. Even though I was given NO insurance.

ObamaCareFacts.com on

COBRA laws are a separate thing. If your COBRA ended you’ll want to look into special enrollment at healthcare.gov ASAP. If you want to just see what happened with COBRA check the department of labor guidelines or try contacting the employer and insurance provider to better understand (you have appeal rights and your employer has responsibilities, but it’s a whole other ball of wax).

Brian on

My benefits previously auto re-enrolled at my company, but this year, that policy changed. Unfortunately, I’m at a remote site and didn’t pay much attention to the enrollment period. I just found out that my company enrolled me in a different plan but, and here’s the problem, dropped my wife and two young children completely.

Now, their telling me that, since the enrollment period is over, there’s nothing that can be done; they will not provide benefits for my family.

I went back to the emails they sent me; there was absolutely no language indicating loss of benefits for my family was a potential outcome for not re-enrolling.

Did my company have an obligation to inform me of the cancellation? Do I have any recourse?

Thanks.

Brian

ObamaCareFacts.com on

You can appeal any insurance company decisions. https://www.healthcare.gov/appeal-insurance-company-decision/appeals/

Amber Taylor on

What can you do if your employer does not give 30 days notice of cancellation of a policy?

ObamaCareFacts.com on

You would likely be entitled to another month on their plan, but either way you should probably enroll in special enrollment while you take up the issue with the employer or another entity.

kevin on

My employer did not inform me that I would not qualify for health coverage after I was offered and agreed to the companies health plan. Is it still the employers responsibility to inform me within 30 days even though the coverage never began?

Jeremy on

What other type of entity. Lawyer? Mine also continued to take our money until another employees wife had a heart attack. Thats how we found out and thats when they stopped taking our money. Still hasnt paid the insurance company or the employees back their money that was taken from checks.
Also, today in a meeting when i pushed this subject they fired me.

Erin on

You may also find assistance with your state’s Insurance Commissioner, you can also try to get help from OSHA (heres a link to some information from OSHA), and you can also call your states General Attorney’s office for advice as well.

Robert Perkins on

I am employed and went to get my medicine Thursday and was told by Kroger that the insurance was terminated. What can I do

ObamaCareFacts.com on

Always follow up with the insurer first and then appeal if needed. You have to re-enroll in coverage every year.

Matt on

Is a company wellness program covered by this law? My company changed the wellness program with 7 days notice before the employee would be solely responsible financially for continuing in the program.

ObamaCareFacts.com on

Yes the law does add a lot to wellness programs, so did updated rules. Does it limit the employer in terms of dropping wellness programs on short notice… I’m not sure.

You can check out the law yourself and do a “command find” for “wellness”. Lots of stuff in here: https://www.gpo.gov/fdsys/pkg/BILLS-111hr3590enr/pdf/BILLS-111hr3590enr.pdf

https://obamacarefacts.com/obamacare-health-insurance-rules/

I’m pretty sure there can be additional rules adopted by states too. Sorry this one doesn’t have a simple answer.

Trevor on

I was previously enrolled in a health care plan my employer provided and i paid my portion. It was supposed to be renewed April 2016. I paid my portion as i have always. i was set to terminate my employment with them 4/9/2016. again i paid my portion (deduction out of pay check). I was advised today 4-14-2016 that my benefits were terminated effective April 1, 2016. i was not advised of this by the company but the store where i pick up my perscriptions. what are my rights and who do i get advice from.

jim on

If a wife is covered under her husbands health care plan and he passes away. Does the 30 day notice still apply for cancellation

Sarah on

I wasn’t informed of the weekly premium increase that would happen with keeping my newborn son on my employer insurance until I returned to work 3 months after his birth. Does this count for the 60 day notice? Or was I supposed to remember that it would cost 550% more a week?

ObamaCareFacts.com on

Is there a specific increase for this? It seems like this would up your insurance to the point where you would then qualify for marketplace coverage for the kid… but I guess this is based on your total household income. Still, sounds like highway robbery.

I wasn’t aware of a mandatory increase of costs during maternity leave, and thus am not aware of a 60 day notice for this.

Maybe try calling the insurer? That is typically my advice when i’m at a loss.

Frank Lee on

What can we do if our employer cancelled our health insurance, gave us notice 11 days after cancellation and refuses to give us any other information. I was literally informed by the registration lady at the E.R.

ObamaCareFacts.com on

Bizarre, you should switch to a marketplace plan immediately, but I think DOL rules say they have to give you more time than this. I’m not sure the exact course of action.

James Julian on

Was in hospital and was going to be released on 4-29 …. Hospital couldn’t get auth. For home care and had me contact my employer to inquire about changes … They told me “oh yeah, we terminated you on 4-27 & your insurance will cancel on 4-30 ?! Can they do this ??

Russell Saulters on

I was laid off on May 30th by my employer with job attached. They dropped my health care plan the day i was laid off. Can they do this without any notice

ObamaCareFacts.com on

As a basic rule of thumb, from our understanding, and as noted above, an employer must give at least 30 days notice.

As for the repercussions of not following the rule, or what you can do, i’m not as sure. I would assume a call direct to the insurer would be a good start, as would be clarifying why this happened with Human Resources or the equivalent at the company.

Tracy Trout on

My employer dropped my dental insurance without letting me know, is that legal?

Melinda on

I was given 2 days notice that I was being dropped by husband’s employers health plan. I got a cobra letter 6-28 for coverage ending 7-1. No reason given, no notification. I’ve been to the dr. twice this year, for a cold and and ear infection. How can they drop me without any notification or without giving me a reason? What can I do?

sarah on

i was terminated at 11:50pm on sunday, and my insurance was cancelled effect monday i was given no written notice that my insurance was being terminated and i was informed that i was no elligable for cobra through my company. Is this legal?

JD on

The Mass Bay Transportation Authority cancelled my life, dental and vision policy for what it said was failure to pay a 24.00 administration fee. I have a paystub that states on the bottom “MSG: your ANNUAL FY16 Adm fee of $24.00 was deducted from your paycheck”. Although when I went to HR they said they actually never deducted it.

Stewart clayton on

Hi my name is Stewart I have a on job back injury I was approved for Long term disability Metlife insurance on 08/03/2016…. while waiting and been denial of Workers Compensation insurance to give help or treatment now my employer now after a week of hasserment and retaliation trying to stop my Metlife disability insurance they send a letter FedEx dropping my health benefits insurance no warning or 14 day notice

Stewart clayton on

Yes my workers compensation AIG insurance

John on

I’m on L&I and my employer canceled my health insurance without notice

John on

I’m on L&I and my employer canceled my health insurance without notice, can they do that?

Gabriela Balczyrak on

My boss cancel medical inshurance never didn’t give nobody note.This was benefit what he took safe money foe hym.He liar whit evrything over time ,holidays, vacations….

TH on

If an employer with 6 full time employees offers health insurance coverage and they decide to not renew the plan at open enrollment is there a required time frame of notice they have to give the employees.

Carroll Vizecky on

What is the Federal Statue that states a 30 day or 60 notice is required.
I was terminated and my position was eliminated as the City Administrator for the City of Freeman SD.
Date of termination September 7th, 2016. I have received no notice about cobra or insurance options. The City did pay my part of the insurance coverage and I paid for the family. I was surprised to learn in less than 10 days I will no coverage at all.
Lost and Confused.

mike cote on

what is considered a material change?

ObamaCareFacts.com on

I think a basic definition is “a change to the terms of a contract” (in this case in an employer health plan contract).

Here is a general definition: http://legal-dictionary.thefreedictionary.com/Material+Changes

Nancy on

My husband was diagnosed with Small Cell Cancer of the Upper Right Lung the Liver Stage IV after being hit by a fork-lift while put his dock plate down on a dock at a delivery in Indy. The ER Doctor came in and said he had good news and bad news. You have no internal bleeding and no broken bones but you have Cancer. His oncologist said we needed to start treatment ASAP and this would weaken him so we requested short term disability which would pay the insurance premiums only to be told that since he was off Jan., and Feb., of this year for Roter Cuff Surgery and therapy that you can’t be on short term disability twice in a twelve month period. So, we asked if we could pay the premiums and the answer was NO. According t the Company he is not fired and is still a employee. Then we were notified Oct., 4th 2016 by phone (not in writing) that they have canceled the insurance effective September 30, 2016. That date would make such that my husband’s first treatment session of three consecutive days not covered after verbally okaying them to the Oncologist personnel and myself.

Please, what recourse do I have to get my husband’s next treatment session covered and do I have a case against the Company? The treatment is my first concern above all and the company issue is secondary at this point. Help Please…

ObamaCareFacts.com on

That is a very sad story. Your best bet is to appeal. If you have no income you can look into Medicaid, which can be retroactive, and you can look into special enrollment for future coverage.

I’m not sure beyond that. But this sort of thing is best handled with appeals and vigilance. One should never just take the insurer or employers word and give up. You can often get the just outcome by putting in effort and following the correct channels. This should set you on the right track: http://www.hhs.gov/healthcare/about-the-law/cancellations-and-appeals/appealing-health-plan-decisions/index.html

Mat on

So if my employer cancels either knowingly or unknowingly my wife’s coverage under my policy without notifying us at all, is that legal or do we have a violation of the law?

Chris Strader on

I got insurance through my employer, and the rate was based Bi-weekly not monthly. Feel like the insurance is way to high for me and the family to afford. Employer says I can not change to lower insurance plan and I may not be able to cancel the insurance either. Does this sound correct sure sound fishing to me.

Jennifer Cramer Hughes on

Can husbands Insurance terminate ex wife without notification when divorce is final?

ObamaCareFacts.com on

Not sure. Once a person isn’t in a tax family then they shouldn’t be on the same coverage. That said, there are general rules for terminating coverage without notice… i’m just not sure about specifics in this case.

Donda Noel on

I as luck would have it work in a Michigan speciality office with less than 20 employees. When I was hired I was told I would have insurance benefits. At time of interview they knew I was separated from spouse. Now 11 mos. later, I was asked if I was still married. And, if I was covered on spouses policy. I advised yes to both and asked why, to which I was told they needed a letter saying I was covered on that policy. Within a day or two, nothing was said to me. Later that night I sent a text to insurance person at work. I asked what date does/did my policy cancel because now spouses HR wanted to know. She replied have the call me on my cell. I thought that was very odd (just tell me the date). Come to find out they cancelled my policy over 2 weeks before even asking if I had coverage and to this day still have not advised me. Is this legal?

Donda Noel on

As luck would have it, I work in a Michigan medical office with less than 20 employees. When I was hired I was told I would have insurance benefits. At time of interview they knew I was separated from spouse. Now 11 mos. later, I was asked if I was still married. And, if I was covered on spouses policy. I advised yes to both and asked why, to which I was told they needed a letter saying I was covered on that policy.

Within a day or two, nothing was said to me. Later that night I sent a text to insurance person at work. I asked what date does/did my policy cancel because now spouses HR wanted to know. She replied have them call me on my cell tomorrow. I thought that was very odd (just tell me the date).

Come to find out they cancelled my policy over 2 weeks before even asking if I had coverage and to this day still have not advised me.

Is this legal?

ObamaCareFacts.com on

I am not sure on the specifics and legalities, but it seems incorrect. I believe there is a mandatory period of notice in general, but the specifics are eluding me.

Cindy on

My union health insurance was cancelled without any notice. I knew benifits were extended for a long period of time after a job ends, but didn’t know how long. I called and was told they had already been cancelled for almost 2 months. They said it was my responsibility to let them know when my job ended. Is that legal? Don’t they still legally, have to give me warning?

Teresa on

Our company is bringing in a new management team to run the company, we was told it take effect December 1,2016. And that our current insurance plans will change to what they feel is equally compare to what we currently have, and we haven’t even had an opportunity to look at the plans they offer. Is this fair or legal? We don’t even know how much the plans are going to cost us per payroll, some people are on budgets , and we can’t even adjust. If we don’t sign up then we will not have insurance come January 1st. So tell me can they really do it like this.

Etoyia Magee on

Hi there, this information was truly helpful!!

Paul on

What are my options if my employer cancels my insurance?

Amber on

My employer sent out an email stating that in order to save costs for them they are switching to a different insurance that will be more affordable to both the company and the employees. We have 3 days to decide to take it with no premiums in place. We have stressed to them that this is illegal but they say that their attorneys claim it’s 100% legal. To me it seems to fall under this law. Am I right?

Mark story on

What constitutes a notice. I was laid-off and had insurance payments taken out of 2 checks after being laid-off. I have not had any actual notice

Heather on

I have been paying for health insurance since I started working for my company. The end of November we found out that out insurance was cancelled in October due to non payment by the employer. What can I do?

Jessica on

Our insurance was cancelled by our employer 8 months ago and we were never notified. We had our yearly check ups and received a letter later that exposed the fact that we no longer had insurance. I don’t think we can even cobra. Do you have any information that would be helpful in this senerio? Thanks

Murali on

Sir my father and mother were paid tn govt health insurance monthly. My father was retired staff. My mother is now working in tn govt. We pay both insurances. So how to cancel or stop my father’s policy. Help me sir
Ph. 9943124282

Donna Cline on

My husband was terminated due to an illness. He went in the hospital on
the 12th, the employer canceled his insurance on the 11th. All the premiums were paid up to date. They didn’t tell him that he was canceled.
Is this legal?

Marie on

I worked for a company in Minnesota that told me about 5 days prior to the last day of my 2 week notice that my medical benefits would term on my last day of employement. I immediately sent an email back to HR asking if I worked one day on the next pay period if I would be fully charged for benefits I could not use. I never received a response. (I travel for work) My last day technically would have been that Friday, but I offered to work Monday if they needed. I just got my final paycheck and they used my PTO and all but 64 cents of what I worked that Monday to pay for benefits I could not use. Is this legal? If not, what actions can I take? I am getting no where with their HR department. They said I should have asked questions….I did. They never responded. Please help! This is morally not right.

Cheryl Rohrenbach on

My husband and I have health care through his employer now they send us a letter saying my husband did not work 780 hours in a 6 month time period so we will be cut off. It’s the law through the affordable care act Is this true?

ObamaCareFacts.com on

If you don’t qualify for full time status, then your employer can cancel your coverage at the end of the calendar year in general. There are complex rules related to measurement periods to consider. If the coverage ended at the end of the year, then this could be correct. If they tried to cancel your policy mid-year, then it could be a more complex problem. From the date of this comment it looks like it occurred mid-year.

Gloria M James on

I am a 62 yr old RN, who has responsibly worked 40 years, with the last 6 yr @ current employer (full time and full medical benefits). I have a number of documented disabilities, and persisted to work with great challenges with employer, but getting some relief with reasonable accommodations.
My physicians ordered me to stop working and completed physician disability forms on 4/5/2017 by neurologist and 4/25/2017 by primary physician. The last day I worked was 4/4/2017. I was on a 3 week medical leave 4/5 – 4/26, with intention to return to work 4/27/2017, which I did not. I have not resigned. I have not been asked yet to turn in my badge. I am still employed, and sick hours used on my time card.
I have NOT received ANY written notice from my employer. I spoke with HR disability specialist who has TOLD me mixed info. At the beginning of May, the HR rep told me with Affordable Care Act, that I could continue paying current premiums (that I have paid while employed) directly to my medical insurance carrier until 12/2017. On 5/22/2017, I spoke with same HR rep, who stated she was now unsure, and that my medical coverage may end 5/31/2017. She repeated her comment, that my case was unique. Again, I stated that I needed confirmation in writing.
Your comment above stated “30 days notice for any reason, but did not specify if verbal or written. Does it need to be in writing, or verbal? Does an employer need to give me of the status of my medical coverage / job status, in my case when I am in the process of full permanent disability?

I need to know. My health care coverage, and budget to sustain living expenses depend on this.

Thank you!

ObamaCareFacts.com on

If you need a very specific answer, you might want to try the department of labor. To answer the question generally: In general there is supposed to be a written notice 60 days in advance changes and 30 days for cancellation. See the following links for some alternative reading material. Those are the basic rules, things can get a little complicated when it comes to specific rules employer and employees have to follow in specific situations.

http://hrdailyadvisor.blr.com/2015/09/10/ask-the-expert-notice-of-health-insurance-cancelation-and-termination/
https://www.zanebenefits.com/blog/bid/310976/the-aca-s-60-day-notice-of-material-modification
http://work.chron.com/can-employer-cancel-health-care-benefits-telling-me-25295.html

Rebecca Patterson on

My employer dropped the insurance company that I have been using for a year or two ,they gave me No notice now I have no insurance,is there any recourse

ObamaCareFacts.com on

Generally they can’t just drop your insurance like that. You should start by talking to your employer and the insurer. You can move onto filing an appeal. Generally there are rules about giving notice and waiting until the next enrollment period. However, rules for employer can be a little complicated so it helps to find out more about the specifics.

Nedra on

Does this include when one quits a job? My daughter only got 2wk. Notice. What can she do….

ObamaCareFacts.com on

If you quit your job or retire, you’ll get a Special Enrollment Period allowing you no less than 60 days to enroll in the Marketplace before your employer plan ends.

Please note that if you lose your coverage, for any other reason other than non-payment, fraud, or misrepresentation, you are typically granted a 120 day special enrollment period. This period typically starts 60 days before you lose coverage and lasts 60 days after.

https://obamacarefacts.com/questions/if-i-quit-my-job-do-i-qualify-for-special-enrollment/

TIP: With Trump’s rule changes special enrollment options have become a little more limited, so I would call heatlhcare.gov immediately to coordinate coverage.

Steve on

My wife is covered under my Cobra. My former employer changed insurers and gave us 3 days to accept the new coverage or not. It is my understanding that employers are required to provide at least 30 days notice of a significant change in coverage. Is that true?

Erin on

I am almost positive this is the case. I’ve never heard of a 3 day limit. You should check the DOL (department of labor) website.

james johnson on

My employer cancelled my health care insurance they said it was cancelled on 6 12 17 they did not tell me until 7 3 17 I had medical services done between those dates. they sent me no notice before they canceled me. Can they do that. I am disabled and live in St Louis Missouri

ObamaCareFacts.com on

You can appeal this, although it could be complicated. I would probably start by calling the insurer, but I’m not sure who the appeal would ultimately go to, the insurer or the employer. You’ll likely need to contact both.

Jason on

My employer is based out of Texas but I work in Boston. They jut gave me 2 weeks notice that my insurance will end. However the policy has been cancelled and backdated to May first due to my employer not paying the premiums even though they deduct the $$ from my check.

Maegan Anderson on

My employer notified us on oct 31st that effective Nov 1st they we’re changing providers . Also till this date when I call the new insurance they state my benefits are not visible and my employer has not provided us with any coverage details. Is this legal?

m taylor on

Our open enrollment is in August; our plan year begins on September 1. On November 15 we were notified that our traditional benefits plan will be changed to a high deductible plan a of January 1 (45 day notice). Does this violate the 60 day rule on a material benefits change notice? And, can an employer change the health insurance after open enrollment (and during the plan year)? Additionally, the plan is only being changed for non-union employees.

ObamaCareFacts.com on

I don’t know the answer to those questions, but I will leave your comment here in case someone else has insight.