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My company recently switched insurance providers and the emails with instructions on how to choose your options (health insurance, disability, etc) weren't sent to my correct email. There was a typo in the email address that the HR head was sending them to and now apparently I'm outside of the enrollment period or some such.

I think that i's pretty awful that I can't enroll until the next calendar year, now, because of something that was beyond my control.

Do I have any options or am I just out of luck?

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    Do I have any options What options have you tried? Have you asked the plan administrator? Was the plan change communicated in any other manner (i.e. regular mailings or company announcements etc.)?
    – dwizum
    Commented Aug 29, 2019 at 16:12
  • It was communicated via an announcement but the specifics were not communicated. All that was made was a generic "we're changing providers" sort of announcement. I asked the plan administrator and they basically implied that I'm S.O.L., which peeves me off a bit since this isn't my fault and idk what I could have done differently..
    – neubert
    Commented Aug 29, 2019 at 16:22
  • Was the email a personal one or a work one?
    – thursdaysgeek
    Commented Aug 29, 2019 at 16:25
  • It was a work email - they just typo'd it. Instead of [email protected] they did [email protected] and kept on doing it. I mean, ideally they would have gotten a bounced email back but I guess that would depend on how your email was setup. I think we may have a catch all email address through Gmail? idk
    – neubert
    Commented Aug 29, 2019 at 16:26
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    Your organisation should use email lists that are managed by IT. Not having an insurance plan administrator manually [mis]typing peoples' names.
    – Lightness Races in Orbit
    Commented Aug 30, 2019 at 17:07

7 Answers 7

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You have some options, but there are a few things to be aware of upfront:

First, confirm that the issue was actually on your employer's side (if possible). If it's an internal list of emails that HR compiled and a staff member mistyped your email, that's the HR department's fault. If, on the other hand, you filled out a form for your company and mistyped your own email address, which was then blindly passed on to this process, then blaming your employer will be tricky at best.

Second, understand that given the structure of your employer's contract with this insurer (and the nature of the health insurance business in the U.S.) it may not be possible to get coverage through this insurer or access your employer's plan for the upcoming coverage year. A given insurer might flex the rules (I've seen it many times in many situations), but they generally don't have to-- there is no "oops" provision in insurance contracts.

Third, your employer may well take the position that you had some responsibility to follow up on apparent issues in the process. If they announced a coming email with new insurance enrollment information, and you didn't get any such email for a few weeks, they may say that you should have inquired further. Whether or not it's actually reasonable in this case, it's not unlikely that your employer will say you had some agency and responsibility here (even if the mistake was not yours).

Fourth, your employer may have budgeted $X per employee with a given insurance option, reflecting premium rates offered by the new insurer for all of your employer's staff. Even if they were to give you this money in cash, it may not match up well with rates offered on plans that are actually available to you (such as a policy purchased through an ACA exchange).

So, with those out of the way, the situation is this: based on what your plan administrator said, this insurance policy may be out of reach for you until next year. This is a bizarre enrollment period (those are typically September - November or so), but if that's what the contract states and the insurer is not willing to cut you any slack then you will have to look elsewhere for coverage. I personally would press the plan administrator a bit harder on whether or not the insurer is really unwilling to offer leeway, but it could be the case.

Employers in the U.S. don't have to provide health coverage directly, though they typically have to offer it or extra pay as a voucher for you to put towards an individual health plan. It's worth pushing that angle, since your employer's apparent mistake has deprived you of either option. And, since they aren't paying any portion of a premium for your health insurance, the money they had budgeted to do so is just sitting in their accounts. It may be a relatively easy shift for them to give you the extra money as long as you can demonstrate that it's going to health insurance premiums.

Do some research on health plans available to you as an individual consumer. The ACA marketplaces are a good place to start, but you can also talk to insurance brokers in your area. Coming to your employer with a solution and hard numbers may be more persuasive to them:

Because of a clerical problem from HR, I've been shut out of the company health plan. I found this insurance plan, which conforms to ACA rules about obtaining coverage not offered by an employer, which would cost $X per month. Since the money originally budgeted for my premiums through the company plan isn't being used for that purpose, I'd like to apply it to this alternative plan until things can be sorted out during next year's open enrollment period.

tl;dr:

  • It is entirely possible that you will not be able to join the company health plan. This is ultimately up to the insurer and may not be something that your employer can affect at all.
  • It's worth pushing your plan administrator on whether or not the insurer truly won't accept you into the plan, and if so you may be able to get some additional money from your employer to put towards premiums for a different health insurance plan.
  • Finding an individual insurance plan will likely involve higher premium rates for similar coverage.
  • Your employer will likely argue that you had some responsibility to be proactive in this process, and by not doing so have implicitly declined insurance coverage or at least are partially to blame for the situation.
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    This somewhat overlooks how strong an argument the employee actually has, as the use of only a never-confirmed personal email address as the only means of communication is itself an apparent violation of a number of employer notice laws, not just a failure to deliver the open enrollment notice but also a failure to deliver many other legally required annual notices typically bundled with the open enrollment package for the employer's convenience.
    – Chris Stratton
    Commented Aug 30, 2019 at 14:30
  • @ChrisStratton The OP is welcome to argue whatever they want, but a lawsuit will be slow, expensive, and likely not capable of getting the OP onto the insurance plan. Unless the legal remedy is something other than the OP getting money to buy insurance elsewhere for this coverage year (IANAL, other outcomes may well be possible), I don't know that the OP's legal position does them much practical good, however strong that position may be.
    – Upper_Case
    Commented Sep 4, 2019 at 0:52
  • A lawsuit would not be a practical remedy. However, violation of the law by an employer may well prove to be a circumstance allowing an exception to the deadline - just as typos on the enrollment forms have been determined to be. And it is also moral justification to leave and seek a responsible employer.
    – Chris Stratton
    Commented Sep 4, 2019 at 1:12
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Your fist step should be to contact your boss. Explain the situation, and see what he thinks you should do. He will probably get in touch with the HR department, since it was their mistake. Assume it was an honest mistake, and that they'll try their best to help you.

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    This is a straight-up HR issue, regardless of how it happened. As the other answer stated, this is likely part of the contractual relationship between the employer and the insurer. There are some times when asking a manager an HR question is the best approach, but those are the time when the manager can actually DO something, or has some insight. For example, if a benefit (such as marriage or bereavement) has a fixed length, but you want more. Speaking to the manager to "pre-clear" the extra time would be helpful.
    – Julie in Austin
    Commented Aug 29, 2019 at 18:47
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    One of the reasons to involve the asker's boss is that failure to fix this administrative error may well make it impossible for the employee to remain with the company. If they have to change jobs to get insurance, they may well have to change jobs to get insurance. In the US this is not a minor perk, but a rather fundamental part of employment compensation.
    – Chris Stratton
    Commented Aug 30, 2019 at 13:34
  • Yes, but it remains a "Human Resources" problem. Managers are supervisors over their employee's problem or task domain. The only time asking a manager about "Human Resource" issues is the first choice is when the manage is a human resources manager.
    – Julie in Austin
    Commented Aug 30, 2019 at 23:02
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I would like add another thing to try if the advice given in the other answers fails: You can add/drop/change insurance outside the designated enrollment period when you experience a qualifying event. These are gain or loss of a job, plus family-related events (marriage, child birth or adoption, death, etc.), because those could up-end the original calculations you made when enrolling (or choosing not to; these are the rules for enrollment both at any place I ever worked and under the ACA; you may want to double check they apply to you as well). The family events are (most likely) not relevant here, but if you were to get fired and rehired shortly after, this should trigger a new chance to enroll, as it would be qualifying event.

Obviously the first thing would be to let your employer negotiate with the insurance (see Upper_case's excellent answer), and realistically this will work, since more insured are in the insurance company's best interest (unless you are a serious risk). But if they don't budge for whatever reason, it is time for desparate measures, and your employer should help you generate a qualifying event, since the whole mess appears to be their fault (at the very least they should have noticed a bouncing e-mail and contacted you by other means). If they don't care enough about your health and would rather throw you under the bus than move a finger to help you, it may be time generate a "qualifying event" yourself and find a better place to work ...

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  • This was done for me by a former employer when I had ticked the wrong box on a form. I sat in the HR office looking desperate and repeating "gotta fix this" until they made up some qualifying event to justify the action.
    – stolenmoment
    Commented Aug 30, 2019 at 13:10
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My wife found herself in a similar situation many years back--the agent failed to contact her and register her. Fixing the situation appeared to be hopeless until my wife figured out who the agent's boss was and called him. Turns out what was really going on was the agent didn't want tell his boss about the oops. She was correctly put on the plan at that point.

Note that the mistake was from the insurance company agent, not from anybody at her employer. I suspect things wouldn't have played out the same if if had been HR's fault.

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In the United States the issue is that open season/enrollment periods and Qualifying Life Events are a part of tax law. They want people to make decisions about health care and not postpone their decisions, so the deadlines encourage people to make a decision.

If you have missed that window from your employer you have to make sure you make the windows defined as part of the Affordable Care Act. I would go to HealthCare.gov to make sure you are still in those windows.

Unless HR knows of a loophole, and you can encourage them to accept fault, then your options are limited. You might have to wait until the next open season or until you have a QLE.

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Do not accept "NO" for an answer here.

Either the current employer takes responsibility for their mistake in failing to actually provide legally required notices and finds a way to enroll you in insurance this cycle.

Or else it is time to start looking for a new job where you are eligible to enroll in insurance and where the traditional multiple means of communication and are used for critical employment information.

In a civilized country, health insurance would not be the huge employment-tied expense that it currently is in the US. But the fact is what it is - losing your insurance is losing a huge part of your employment compensation and should basically be viewed as making it impossible to continue employment there.

A smart employer will understand this reality and find a way to fix their mistake. A shortsighted one will lose an employee over this.

Because this issue threatens your ability to remain with the company, you should pursue it not only via HR, but also in parallel raise the issue with your manager - losing an employee threatens the continuity and progress of their projects, so their influence can help in getting the problem promptly corrected.

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Just find the HR person who is looking into that, invite him over a beer, and explain the situation. He will understand, or not. In any case, just try and fail but dont try to fail.

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