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About my health benefits from my job?

  • I'm a female and I am an employee (full-time bank teller) with Bank of America, in Atlanta Georgia. The health benefits that they provide are through Aetna and they provide me health, dental and vision, and no maternity or OBGYN coverage, which is okay with me. However, I've NEVER used the coverage, and I became pregnant and stayed away from work on unpaid leave, and my fiancee (now husband) was supporting me paying all my bills, before he became ill, and now he himself is in hospice and is sick. Meanwhile, we did not pay Aetna for (2) reasons: the amount owed became outrageous since they were not able to collect anything from my payroll check from the bank, since I was on UNPAID leave. And secondly, Aetna did not want to accept my offer of $100 per month for a $600 bill, which I think is ridiculous. They said that they could not accept a payment arrangement, but they could arrange for monies to be taken from my check. On another note, today, I opened my check, and for a third time, $300 is missing. I have some savings and family members are helping me, but these things will soon run out, and that coupled with this situation with Aetna could cost me everything, my apartment and car. everything....all because of Aetna. My credit is in the 800s, THANK GOD, which gives me no reason at all to file bankruptcy, which I don't think would even help a health benefits case anyway. Also, please understand that Bank of America has NOTHING to do with this. They always transfer me to Aetna when I call. Tomorrow is Monday, and I'm calling first thing in the morning to see if they will cease collecting money from my check. I'm not trying to avoid paying the bill, but I cannot do it on their terms, and what's more, I did not sign anything. The benefits package was sent to me after I clicked a "yes" box on my Bank of America employment application, when it asked did I want to enroll in benefits. There was nothing in the benefits packet that said anything relating to what they're doing to me. I do have an attorney, but since I'm paying them through a payment plan, the work that they do for me is limited until they're paid in full. So My question is this: Does Aetna have a legal right to continue to do this, causing me to lose everything? Please advise.

  • Answer:

    Your employer chose NOT to include maternity benefits with their employment package. They can do that. Once you're not working, your employer doesn't "kick in" a large chunk of your insurance coverage. This isn't Aetna or your employer being a meanie, these are IRS laws, so thank your elected politicians. You can't "negotiate" a lower price for health insurance. Insurance rates are set and approved by your state insurance commissioner, and there is no negotiating, just like you can't go to the gas station, and offer to pay $5 a week, to fill your tank up once a week. It doesn't WORK that way. Either you BUY the coverage, and you PAY for it, OR, you don't get it. Period. If you're talking about some uninsured medical costs - it's not Aetna you're negotiating with. If you've had Aetna pay some of your claims, AFTER your insurance was cancelled because you didn't buy the continued coverage, again, YOU owe them this money, and they don't have to take any payment plan!! Not only does Bank of America have nothing to do with this, most likely, Aetna has very little to do with it, also. Once you elect benefits, the IRS states you have to KEEP those benefits, until you lose your job, or the next year's open enrollment comes along. The IRS also says, your employer is NOT ALLOWED to pay for your health insurance, or contribute towards it, if you are not actively working!! So you're legally not allowed to drop coverage unless you quit, and you HAVE to pay the FULL premium yourself. And these are IRS laws, not the insurance company, not your employer. Your attorney should have EXPLAINED this to you, seeing as how you're probably paying them MORE than Aetna or the hosptial is looking for. It's not AETNA causing you to lose everything. It's having an uninsured birth and uninsured disability time, and not having enough savings to carry you through the dry spell, that's causing you to possibly lose everything. Uninsured medical costs are the #1 reason for bankruptcy filings in the USA. If you don't want it to happen again, you'll get full health coverage, with decent maternity benefits (maybe through your husband), and you'll bend over BACKWARDS to keep the coverage in force, even if it hurts.

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