Question
What is the name of your state? New Jersey
My next door neighbor was rushed to the hospital by his brother the other day. He was doubled over in pain and could barely get himself in the car. Turns out that he needs to have his gall bladder removed. It also turns out that his boss let his medical insurance lapse without any notification. Until today, he thought he had major medical insurance. Does he have any legal recourse?
Answer
I'm interested in finding out what, if any, recourse he has also.
Answer
That depends.
You say, the boss let the coverage lapse. Does that mean the coverage was cancelled for non-payment? How long ago? If it JUST happened, like within the last 30 days, unless it is a chronic problem it is entirely likely that the boss can reinstate the coverage by making the missing payments now. (As far as notifications go, cancellations for non-payment are ALWAYS retroactive, so again depending on how long ago it happened it's quite possible that coverage WAS in place until just recently, when the coverage was retroactively taken out.)
If the boss deliberately made a conscious decision to forgo coverage in the future, then it will depend on whether NJ law requires notification of the cancellation and if so, when. The NJ Insurance Commission can answer that question for you.
I have to say this. It will also depend on whether the boss REALLY didn't provide any notification or whether your neighbor just didn't read it. I don't know him so I'm not casting any aspersions on him, but if I had a dollar for every time I had an employee complain that I'd never notified them of (fill in the blank) and I was able to reach into a drawer and pull out a copy of the notification, sometimes with the employee's signature on it, I could retire early.
Answer
I have to say this. It will also depend on whether the boss REALLY didn't provide any notification or whether your neighbor just didn't read it. I don't know him so I'm not casting any aspersions on him, but if I had a dollar for every time I had an employee complain that I'd never notified them of (fill in the blank) and I was able to reach into a drawer and pull out a copy of the notification, sometimes with the employee's signature on it, I could retire early.
Just put in their employment contract that when this happens the employee owes you a dollar. Then when it happens and you show them the notice, you can also pull out the employment contract and show them the dollar clause. Put a tip jar on your desk and watch the Aruba fund grow and grow and grow!!!