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  1. #1
    Join Date
    Feb 2018
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    3

    Default Employer Deducted Medical Dues, Did Not Pay Insurer

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

    I recently contacted my unions health trust looking for my 1095 from 2017. Upon contacting them, I discovered that while my employer deducted medical dues during 2017, they did not pay the health trust for my insurance policy. The health trust confirmed they had not received a dime from my employer in 2017 and therefore, I did not have an active policy in 2017. I brought the issue to the attention of my employer, asking where my medical dues went. They admitted outright that although they deducted medical dues from my paychecks, they did not pay the health trust in 2017. Instead of reimbursing my ytd medical dues paid in 2017, they said they would simply pay the health trust for my 2017 policy. I am confused as to how they can simply retro pay for an insurance policy I never had. Thankfully, I went all of 2017 without needing so much as a doctors visit, so I never needed to use my health insurance. Yet, I still feel as though this is fraud, or at the very least, theft. Any advice on what laws, if any, have been broken here would be greatly appreciated. Any advice on how to proceed would be greatly appreciated as well. Thanks.

  2. #2
    Join Date
    Oct 2014
    Posts
    7,857

    Default Re: Employer Deducted Medical Dues, Did Not Pay Insurer

    Without knowing why the payments were not made it is impossible to say if anything criminal occurred. But you are free to report this to the police and see if they will pursue it. I think you ought to continue to press for the company to refund you the premiums paid for insurance you never had. Paying it now is worthless to you and would not have done you any good had you needed to use the insurance last year. My guess is that their claim to pay the insurance after the fact is really an effort to avoid having to pay the money to any one. If I were you, I'd start looking for another job immediately and go to an employer who doesn’t have these kinds of problems. When this kind of thing happens, one of the most common reasons for it (assuming it was not simply some administrative error) is that the company is trying to save money anywhere it can because it is in financial trouble. This is a red flag that may indicate things are going to get even worse the longer you stay.

  3. #3
    Join Date
    Feb 2018
    Posts
    3

    Default Re: Employer Deducted Medical Dues, Did Not Pay Insurer

    Quote Quoting Taxing Matters
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    Without knowing why the payments were not made it is impossible to say if anything criminal occurred. But you are free to report this to the police and see if they will pursue it. I think you ought to continue to press for the company to refund you the premiums paid for insurance you never had. Paying it now is worthless to you and would not have done you any good had you needed to use the insurance last year. My guess is that their claim to pay the insurance after the fact is really an effort to avoid having to pay the money to any one. If I were you, I'd start looking for another job immediately and go to an employer who doesn’t have these kinds of problems. When this kind of thing happens, one of the most common reasons for it (assuming it was not simply some administrative error) is that the company is trying to save money anywhere it can because it is in financial trouble. This is a red flag that may indicate things are going to get even worse the longer you stay.
    Thank you for your reply and I appreciate your advice. My research is pointing me into ERISA violations on top of what could be considered theft... Any thoughts?

  4. #4
    Join Date
    Jun 2006
    Location
    Massachusetts
    Posts
    24,352

    Default Re: Employer Deducted Medical Dues, Did Not Pay Insurer

    It certainly couldn't do any harm to run the question past an employment attorney or the duty officer at the DOL.

  5. #5
    Join Date
    Feb 2008
    Posts
    1,167

    Default Re: Employer Deducted Medical Dues, Did Not Pay Insurer

    Talk to your state department of Insurance and report the situation to the DOL EBSA line. Either should know if this is something you can complain about and will tell you if there would be any repercussions to your employer.

    But dang, that's pretty out there for the employer to think they wouldnt' get caught! How many people are on the plan and could you tell if this was just you as a single employee, or did this happen to others? Were they just hoping no one would notice or they would only pay if there was an actual claim?

  6. #6
    Join Date
    Feb 2018
    Posts
    3

    Default Re: Employer Deducted Medical Dues, Did Not Pay Insurer

    Thanks for the reply. I spoke with someone from the DOL this morning and they advised I do the same- speak with someone at EBSA. There are several hundred employees with the same health plan I was supposed to be on, and so far, I seem to be the only one this has happened to. I’m going to try to speak with someone at EBSA tomorrow and gather more info. I’ll be sure to report back. Thanks again.

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