I live in the state of California.

I amicably left an employer over 2 years ago and have just received a phone call from (presumably) the insurance broker of said employer informing me that medical insurance was not withheld from my final paycheck and I owe them some money.

Am I actually responsible to pay them this money or would it be the responsibility of the former employer?

  • 2
    Joe is correct. Companies pay medical insurance premiums directly, and in lump sums. There is no (conceivable) way just one employee's premium was not paid. – Wesley Long Jun 9 '16 at 0:32
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    Even if there was a glitch, the insurance company would contact the employer, not the employee. The employer, if they agreed, might then contact you about reimbursing them. "This smell many day dead." – keshlam Jun 9 '16 at 2:23
  • Next time they call ask them to send you the demand in writing. If they don't send it, it's a pretty sure bet it's not serious. – Brandin Jun 9 '16 at 7:19
  • VTC as a legal question, but this is almost certainly a simple scam as Joe said. – Lilienthal Jun 9 '16 at 7:40
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    There is no plausible scenario in which an insurance company's accounting department could fail to notice a missing premium payment FOR TWO YEARS. They don't just collect a lump payment from the employer. They also get information from the employer telling them which employees are covered in the payment, and for what, and how much. Employees do not change their coverage ONLY at open enrollment: if major events happen, coverage can change at any time. This is almost certainly a scam. – John R. Strohm Jun 9 '16 at 17:06

If your last withholding for medical insurance was really left out of your final paycheck, ultimately you would be responsible for it to the insurance carrier. The payment mechanism thru the employer, to the broker, to the carrier, is really just for your convenience.

However, do not pay the insurance broker directly. Contact your previous employer directly to resolve this.

If you truly believe this to be a scam, collect information from the "insurance broker" such as where to send the payment, company name, and insurance license number and submit it to your state's department of insurance fraud division.

  • I really don't understand why this was voted down. My answer is correct. – Anthony Genovese Jun 9 '16 at 18:12
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    Paying the insurance is the company's job. He is absolutely not responsible for the insurance payment. If his company made a mistake and overpaid him, they are free to contact him, but they didn't. – gnasher729 Jun 9 '16 at 19:21
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    I have worked in insurance for 10 years. I am not saying this is not a scam. However this is not out of the realm of possibility. If he had medical insurance that month, and he did not pay his part of the premium, then he is 100% responsible for it. Screw ups for insurance premiums happen ALL THE TIME on final checks. They just normally get resolved within a couple months or the employer eats the costs. I stand by my answer - if it was not withheld and it should have, he is responsible for the payment and he should contact his previous employer to address the situation. – Anthony Genovese Jun 9 '16 at 20:23
  • the point is it is nothing to do with the insurance company - as you say in your last sentence this is between the previous employer and the OP – mmmmmm Jun 10 '16 at 15:27
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    I think it may be the way you worded the response agenovese. If I understand what you are saying, the answer is, that while I am responsible for the withholding amount, I would be responsible for it to the former employer but NOT to the brokerage. There is no way I should be paying anyone other than my former employer correct? – S.Nishizaki Jun 10 '16 at 19:55

This why you shouldn't send any money to the insurance company.

They had/have a contract with your former employer. Every month they exchange funds depending on the number of employees covered that month, and any other fees. You are not privy to how partial months are addressed, nor are you sure if the company is self insuring so the actual premiums may have fixed part and a flexible part.

The amount that is withheld from your paycheck is an agreement between you and your employer. They can withhold anything from 0% to 100%, and it can even depend on if you have employee only, employee + spouse, or family.

The insurance company has no idea how much should have been taken from your paycheck. If they believe the employer owes them more money, that is not your concern. If the employer failed to withhold money they should have, that is between you and your employer. Therefore the insurance company should not be contacting you...

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