Question
Is the 2nd appeal process worth it or a waste of my time?
My husband is a 18 year employee for a rather large trucking company. He is young with many health issues including a disease that is leaving him unable to work. He went on STD in September of 2016 and since then has filed for SSI and has an attorney. In the mean-time in April his STD should have switch to LTD (Aetna the carrier) and it did not. Actually they wrongfully terminated him. He has partially be reinstated per say but benefits etc are all not active yet. Aetna is refusing to pay him LTD and cover him because while he was on STD they made a benefit change in October 2016 and made LTD an elected paid for benefit. It has been a company paid benefit my husband’s 18 year career there. Well because he did not participate in open enrollment they are denying him coverage. He was not working and NOTHING about any benefit changes was communicated to him. Mind you we have a family of 5, he has had intermittent FMLA for 5 years because of his declining health and I am a HR Manager… Common sense we watch our benefits and livelihood. There are 2 other employees in my husbands place of employment that say they were never informed either and are now not enrolled in LTD since we have brought to there attention. Is this worth the 2nd appeal process or is it a waste of my time?
Answer
Rebecca, I would certainly say it is worth it. If he filed for disability in September 2016 and the change in premium payment did not occur until October 2016, then he should arguably still be covered under the LTD plan as it was in effect in September 2016. Please feel free to contract our to discuss your husband’s claim further.
