Legal Question in Health Care Law in Arizona

Part 1:

I failed to make new elections on my companies Health Benefits, naively thinking that if I didn't they would drop for the following year. I noticed my mistake in November 2011 and made a written request to our Benefits department stating that I knew I had made a mistake but please honor my request to cancel my insurance as we were not even in the Benefits year in question, 2012. My request was declined and I am now being forced to retain my insurance coverage, since I didn't make new elections, they auto-rolled to the current benefits year.

Part 2:

I noticed my check was consistently short and I proceeded to investigate. Come to find out I am being charged $1000.00/year ($41.66/ check) for a "Working Spouse Surcharge," which is not the case. My wife does not, and is not eligible, to receive insurance from her job. I put in a request to stop this surcharge from being withdrawn from my check, and asked for a reimbursement for the charges taken since 01/01/2012. I thought this was reasonable as it was not my mistake. I just received a notice that this was declined as well due to the fact that "had you made new elections, you would have seen the check box to notate that your wife is not eligible for benefits elsewhere."

My questions are:

A. Am I legitimately required to retain benefits in 2012, if I missed the cut off period during Open Enrollment?

B. Can they continue to charge me the "Working Spouse Surcharge" knowing that my wife does not have insurance elsewhere based on the fact that, "I didn't check the check box?"

I'm sorry this is so long. I just had a lot of information as this has been going on since November 2011

Sincerely Appreciative,

Jon S. Rigg


Asked on 5/17/12, 7:38 am

1 Answer from Attorneys

Joyce Johnson-Stovall Johnson Stovall and Associates PLLC

Your benefits are governed by your employee benefits manual. Without reviewing it, we cannot provide you with legal advice.

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Answered on 5/18/12, 6:03 am


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