Legal Question in Insurance Law in Pennsylvania

Notification of open enrollment in group health plan

I was not offered the group health insurance from my previous employer. I requested the Summary Plan Description. They denied giving me the SPD, saying that I was sent a memo for open enrollment and I did not enroll. I am a remote employee and did not receive any such memo or any notification whatsoever that there was a group health plan. What is the process by which an employer ensures that an employee, especially a remote employee, receives benefit information? Are they required to have proof that it was sent? As far as I know, all other employees in my category were offered group health insurance.


Asked on 9/29/03, 10:46 am

1 Answer from Attorneys
Wayne Wisong Wayne Wisong, Attorney at Law

Re: Notification of open enrollment in group health plan

Contact me by e-mail and I will send you my standard "ERISA request" form. Basically, you are entitled to the SPD if you are or "may become entitled" to a benefit under the plan. You certainly will have later enrollment opportunities. The U.S. Supreme Court has declared a very liberal standard on interpreting that. If you draft the request properly and they do not timely respond with the information within 30 days, you can sue them for up to $110 per day for each day they are late. And retaliation is prohibited by federal law. And, yes, if they never sent you the notice, this further weakens their position. My e-mail address is [email protected].

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Answered on 10/07/03, 6:21 pm


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