A county uses a standard process to enroll new employees in health insurance. That process requires a third-party administrator to enroll the new employee after the employee is entered into the county’s HR system. The county has no control over the administrator’s scheduling of new employee enrollment meetings.
In this case, the county hired an employee at a salary level that required the county CEO’s approval. The time needed for that approval delayed the employee’s entry into the county’s HR system until November 30th. The third-party administrator contacted the employee that day and held an enrollment meeting on December 2nd.
The employee became a plan participant effective January 1st, with medical coverage beginning February 1st, after the required 30-day waiting period. To maintain continuous coverage, the employee paid one month of COBRA premiums for the insurance he had from his prior employer. The employee then filed a grievance against the county seeking reimbursement for the COBRA premiums.
The arbitrator rejected the employee’s claim that coverage should have begun on January 1st. The arbitrator found that the county made no promise or guarantee regarding when health insurance coverage would begin. The arbitrator noted that the employee met with the benefits administrator within 30 days of eligibility, as required by the health plan enrollment guidelines.
The arbitrator found no MOU violation and determined that the county timely and properly enrolled the employee in health insurance coverage.