Can I force my company to pay for dental costs incurred if they change coverage without alerting me?

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Can I force my company to pay for dental costs incurred if they change coverage without alerting me?

My company’s dental insurance plan will cover up to $2000 of dental work. If my company changes the annual renewal time and doesn’t tell us, what is its liability. For example, I go in to have a root canal thinking that I have another $2000 to use but I get a bill for 1k since the insurer says I’m already at my max, can I force my company to pay? Basically because they didn’t alert me that they changed a 12 month insurance period to a 13 month insurance period?

Asked on April 9, 2012 under Employment Labor Law, Maryland

Answers:

SJZ, Member, New York Bar / FreeAdvice Contributing Attorney

Answered 11 years ago | Contributor

A company may make changes in coverage going forward, from when they announce the change. They may not retroactively or after the fact (i.e. after a cost or bill is incurred, or medical services provided) change coverage to an employee's detriment; doing so is effectively a violation or breach of contract, since it is to not provide the compensation which you had performed the work/employment for.

However, a  company does not have to go out of its way to make sure an employee knows  of a change--therefore, while if there was no notice of the shift, the company would seem to have to reimburse you for this cost, if there was any memo, announcement, email, etc., previously, then even if you personally forgot it, didn't pay attention, etc., the company provided the requisite notice.

Note, however, that even if the company should pay for this dental work, if they refuse to do so, you'd have to sue your employer for compensation, which has its own obvious costs.


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