| Investigation of ESI America, Inc. Lapse in Health Insurance Coverage |
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| The NCDOI is investing ESI America, Inc. (ESI) for possible violations pursuant to North Carolina General Statute 58-50-40, willful failure to pay group insurance premiums and not giving notice to persons insured at least forty-five (45) days before termination of group insurance. |
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| As part of the investigation, data needs to be collected from former employees on premium dollars withheld from employee's paychecks. Data also needs to be collected on uncovered medical claims resulting from a lapse of coverage with Partners for the months of July and August 2002. |
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| ESI employees must complete a proof of claim form for every individual with claims and return the form to the Department by October 31, 2003. The September 16, 2003 letter with proof of claim forms was mailed to all known ESI employees. Letter and Claim Forms provided in PDF format below: |
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