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Today, I have received a call from my uncle asking for advice. Apparently, his company had deducted from his payslip a portion alloted for Maxicare. This happened in December 2013. He was never regularized nor was he given a Maxicare card. He now no longer works for that company and he wants his money back.
First, let's start that the issuance of Maxicare cards is dependent on the company policy. The company policy may either be the date of regularization, date of hire or standard cut offs. This company policy must be made known by the company to Maxicare prior to entering into an agreement so that Maxicare can execute those enrollment guidelines once the contract has started. The contract between Maxicare and the company will stipulate the company policy of issuing cards. The timing of the issuance of Maxicare cards is not Maxicare's policy but the company's policy and that Maxicare is just there to execute.
After initial verification, my uncle was never enrolled in Maxicare, which means 1) his name was never submitted for enrollment or 2) his name was submitted but never processed by Maxicare. Granting that the former is correct, the company may have charged him in advance. He must file for a claim from his former employer and not Maxicare.
Collections between Maxicare and a company is not done individually. The contract is between the company and Maxicare and not between the member and Maxicare. A lump sum cheque is issued by the company to Maxicare. The manner as to how this lump sum amount was derived is internal to the company, whether this was paid for by the company in full or the employees had a portion of the share. Any deductions from your payroll or receivables from your last pay must be settled internally.
