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Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.


Lost Coverage on Maternity Leave

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Question: I have been working for my company for 11 years I went on maternity leave and then my daughter had health problems and I developed post partum and couldn't return back to work, my company said no problem and continued to pay my full premium ever month I am now back to work and the health insurance company is fighting with my boss and wants to drop me from the plan are they allowed to?

Answer: I think I understand what happened and it's really bad luck for both you and your employer. The employer's health plan contract with the insurance company defines a specific length of time employees are to be covered while on maternity leave. Apparently you were out longer than the contracted time. Normally, this is something that would not come to light as long as your employer continued to pay your health insurance premium each month you were out. However, the insurance company will routinely re-certify a health plan and that includes a review of the most recent payroll tax records. If you did not appear on the payroll, you should not have been covered. The insurance company has the legal right not to pay your claim and rescind your coverage. It sucks, but it is what it is.

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