Question
What is the name of your state? South Carolina
My friend's husband turned in his 2wk notice on September 16. The company told him to not finish his out 2wks but to consider that day his last. He had taken that day off because his wife was having a small outpatient surgery that day.
Now the Insurance company is claiming that they are backing up his termination date to the 13th and therefore, the surgery took place AFTER his termination date and they will not cover the cost of this surgery.
1) do they have a leg to stand on to appeal this call
2) is there not some kind of "grace period" in coverage
3) If he is paid weekly, and a premium is taken from his paycheck each week, and he was paid his final check on the 19th, shouldn't the company have some responsibility?
Answer
1. Maybe. It depends entirely upon what your friend's employer's group health plan calls for relative to cancellation of coverage when employment ends. There was nothing whatsoever preventing his employer from accepting his resignation immediately however.
2. No. Some Plans call for cancellation at the end of the month for separations that occur during the month but that's not a grace period and there are no laws that require employers to extend coverage past the last day of actual employent. Your friend may qualify for continuation (at his cost) of his current plan through the employer under COBRA legislation.
3. No. Again, the answer to your question resides entirely in the Plan Document/insurance booklet that will detail when coverage ends following the end of employment. Your friend needs to locate the copy he was given when he enrolled in the Plan.