Not Informed of Benefits for 7 Months

[MrsMoreno]

My question involves employment and labor law for the state of: CA

I work for a supermarket chain and am a union employee. I have been at my job for a little over a year and a few months ago started wondering why I hadn't received any information about my medical insurance benefits. I asked my manager and assistant manager when I became eligible and they both told me not to worry that I would be sent the information when I became eligible. So I waited. Another couple of months passed and still no benefit information. I brought the issue up again with my store manager and he told me it "wasn't their thing" and that I needed to contact my union. I did so and was told that they had nothing to do with benefits, contracts only and that the employer was the one responsible for getting this information to me but was told I should get something in the mail soon. Another month or so passes and still nothing. Another round of phone calls and still no answers. Finally a couple of weeks ago I was informed (by the union) that there is a third party trust that distributes the benefits. I contact them and find that I am in their system but they have no address or phone number for me. This is because they have never received the enrollment form that was supposed to be in my "new hire packet" - no mailing address = no benefits information. I called my boss to ask why/how this happened and he acted as puzzled as me claiming it "made no sense" and that he would get right on it. Once he found out that I had already requested the form from the trust he didn't understand what the problem was or why I was upset at missing out on 7 months of medical benefits. Come to find out there are several other employees that have had this happen, according to the union trust. So I bring this up to my asst manager and he pulls the new hire packets out to show me that the enrollment forms should be in there and when he looks, finds they are not in the packet. Today I contacted my union rep and he stated that the forms should indeed be in the packets as he makes them and delivers them. He also stated he had never heard of that happening to anyone and I informed him that the trust has had this happen before with several other employees. He tells me that it is "of no benefit to the employer to do something like that because they have to pay for the benefits anyway". Paying the minimum premiums while incurring no other costs does seem something a big corporation WOULD do, and the evidence points to that being the case. What should I do about being compensated fro the 7 months of benefits I never got? Can I insist on being covered for 7 months going forward even if I will not be employed by them any longer (I am turning my 2 week notice in tomorrow)?

Thank you for any advice/help, I am at a loss as to what my rights are in this situation. It seems like what they are doing is deliberate.

[cbg]

I'm asking these questions to help assess your legal situation; I am fully aware that there are additional issues over and above this one. I'll address them, but I need these answers first.

What actual medical expenses have you incurred in the last 7 months? How much have you paid in medical bills that would have been covered by insurance? With the understanding that anyone can walk out into the street and get hit by a bus at any time, what kind of medical bills do you anticipate having going forward?

There is no possible way you can continue to be covered by them once you are no longer employed by them. That is not going to be a viable option, whatever other solutions we may come up with.

[MrsMoreno]

This is the part 2 of my issue. I am on Transitionary Medi-Cal. I had no idea that I was covered under my job and had a couple of doctor visits (2 of them being work related injuries that I went to the ER for since I have no PCP & that I was asked not to make claims for by my boss). He knew I was on medi-cal and I'm sure he also knew that I qualified for benefits after six months - he would not give me this information after I asked him on multiple occasions. So this has become a major issue for me because now worry I may face trouble with the state for using medi-cal while I was eligible for other benefits. I am unsure as to the amounts of my medical expenses as medi-cal does not send statements, though I can probably request them. I had also been waiting for these benefits to see a specific therapist (for some personal issues) that takes blue sheild insurance but not medi-cal.

[cbg]

Understand that you cannot give me exact amounts - can you give me a guesstimate? This information is helping but give me just a little more.

I'm working towards something specific - I"m not just fishing aimlessly.

[MrsMoreno]

I see. Let me call Medi-Cal tomorrow and see if I can get a figure for the last 7 months. As far as the therapy, it would've been $80 - $120 per session (per his site) and the sessions would have been once a week. So were I to see him for 7 months, it would have been ballpark $3000 if I average the session cost.

I will get back about the other costs tomorrow, thank you so much for your help!

[cbg]

That will help. It doesn't have to be exact - just a general ballpark so I can make an estimate.

[MrsMoreno]

I just spoke with a supervisor at the Medi-Cal office, he's looking it up and will get back to me soon. I also asked that he mail me a copy as well. If I don't hear back from them by 3, I'll call them again. Thanks again.

[cbg]

If you want to PM me the information instead of posting it publically, that's fine. What I'm trying to determine is the most cost-effective solution for you.

[MrsMoreno]

I should be getting the info tomorrow. Due to hippa laws, they have to go through a specific privacy procedure. I have had to call 6 different numbers to get to the correct dept! I will PM you the claims info as soon as I get it.

[cbg]

Aw, honey, I don't need the info that much! Thanks so much for being so helpful. Since you've got it, or are getting it, we might as well use it, but I didn't mean for you to go to that much trouble.

When you send me the numbers, would you also send me what the insurance would have cost you if you'd had it,, and what you pay for the Medi-Cal. I know what answer I'd give you if you didn't have ongoing medical issues, but I'm concerned about the fact that you have more to come, and I want to give you the best options possible.