Health Insurance benefit taken away without notification

Submitted by kellyforde on Tue, 12/06/2011 - 11:45

MA Employment Law (Workplace/Coworkers) Questions and Answers

My husband is a public school teacher in MA. We recently found that as of July 2010 his employer has opted out of covering services related to Autism. We have an autistic son, and until now, his services were covered by our insurance. We were never notified of this change, and only found out through his therapist because she wasn't getting reimbursed. Didn't his employer legally have to notify us of this change/loss of benefit?

Health insurance and autism

Submitted by The Editor on Tue, 12/06/2011 - 14:18.

I beleive that under ERISA, if your employer makes "material changes" in your health plan, you are supposed to receive notification via a form sometimes called a Summary of Material Modifications, within 60 days of the change. This is not really an area of the law that I know much about, however. Try the website of the US Department of Labor, Employee Benefits Security Administration.
Also see Massachusetts General Laws Chapter 207, regarding insurance coverage for autism. Good luck.

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