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It's Been This Way For Over One Year!!

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  • It's Been This Way For Over One Year!!

    Long time reader and it's been a long while since I last posted.

    BG: I work in an office that handles employee benefits. We don't pay claims, mainly set up and administer benefit plans for small companies

    Yesterday, a service rep calls me over to look at an employee application. My writing is on it stating "single coverage, no eligible dependants". I take a look at the printed off email between me and the person who sold the plan (the advisor) and it states "as discussed will remove dependant from application". The service rep then asks me to look at my emails and see if there's anything else there I can send her that's not in the file. I do so. Can't find anything. Huh that's weird... but wait. I go back to look at the email printed off... IT'S FROM 2015!! and I just deleted all my 2015 emails in January since I thought "No would ask about anything that happened over a year ago"

    Apparently, this employee was supposed to come onto the plan with family coverage back in 2015. The only reason I could think that his dependants were not eligible is because they didn't live in Canada. That's just how it works. But apparently, she's been living in Canada this whole time.

    But wait a minute, I sent this email to the advisor and received no arguments. We then issued a benefit statement showing single coverage and only sent out one drug card for the employee. You're telling me it took over one year to realize this was wrong?!

    Hopefully I'm not in trouble for this, but I have enough documents to prove I wasn't in the wrong.

  • #2
    You would think that the employee would have noticed when they got the card and their dependent wasn't listed on it. Maybe the dependent didn't need medical help throughout 2015?

    The only thing that I think might come back to bite you is that you didn't print out the email that explained why the dependent wasn't eligible. But if that part was done by phone, then you wouldn't have written record of it.
    "I look at the stars. It's a clear night and the Milky Way seems so near. That's where I'll be going soon. "We are all star stuff." I suddenly remember Delenn's line from Joe's script. Not a bad prospect. I am not afraid. In the meantime, let me close my eyes and sense the beauty around me. And take that breath under the dark sky full of stars. Breathe in. Breathe out. That's all."
    -Mira Furlan

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