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AlexiaEsq.
AlexiaEsq., Managing Attorney
Category: Consumer Protection Law
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Experience:  19+ Years of Legal Practice in Consumer Protection.
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I resigned from my job with medical insurance coverage. When

Customer Question

I resigned from my job with medical insurance coverage. When I submitted my writen resignation (30 day notice) I asked the HR person to check with our insurance company about COBRA as I have a chronic illness. She checked and was told by United Health Care that I would have to wait until the employer sent me a COBRA package. My last day of employment was 11-05-10. I received a COBRA package on 03-04-11. I am now having to pay full premium for mine and dependent coverage through February 2011. I was not given an option of changing coverage until March 2011. I did not continue my dependent coverage because of the cost. Is there not a reasonable time limit on COBRA's. This cost me about $2400 in dependent coverage which I would not of otherwise elected. This is a very large medical company that I worked for (SAVA SENIOR CARE).
Submitted: 3 years ago via Cornell Legal Info Institute.
Category: Consumer Protection Law
Expert:  Ely replied 3 years ago.
Hello,

Welcome to JustAnswer and thank you for the opportunity to assist you. Please remember that there might be a delay between your follow up questions and my answers because I may be helping other clients or taking a break.

I am sorry, but I am a little confused as to your question - are you asking how long COBRA can last, or if you have the right to modify coverage while you have COBRA, or something else?
Customer: replied 3 years ago.
How long does a company have to offer you a COBRA package once you have terminated your employment. There is a law HIPPA with portability regulations for medical insurance companies
Expert:  Ely replied 3 years ago.
Federal law allows you the right to continue your former employer’s group plan as individual or family health care coverage for up to 18 months at your own expense.

This is indeed a law about portability as part of HIPAA. It is pretty lengthy, but you can see a summary which addresses your situation as well, here:

http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html

I hope you found my answer helpful, and if so please click on the ACCEPT button. This is the only way for me to get credit for my work; I receive no credit for my time with you until you actually press ACCEPT. If you still need to clarify something or seek more information, just use the REPLY button and I’d be more than happy to follow up to your satisfaction! There is no fee for follow up questions before or after accepting, should you wish to continue in the thread, and I encourage you to do so should you desire clarification.

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Customer: replied 3 years ago.
NO YOU HAVE NOT ANSWERED MY QUESTION. I KNOW THERE IS A LAW ABOUT PORTABILITY BUT DO NOT KNOW THE DETAILS
Expert:  Ely replied 3 years ago.
I am sorry, allow me to remedy that. You stated that There is a law HIPPA with portability regulations for medical insurance companies, but I am unsure as to what specifically you seek to know about this?
Customer: replied 3 years ago.
How long does a company have to offer you a COBRA package once you have terminated your employment? If portability is only 63 days is it right that a company takes 120 days to offer you that coverage?
Expert:  Ely replied 3 years ago.
How long does a company have to offer you a COBRA package once you have terminated your employment?

Eighteen months.

If portability is only 63 days is it right that a company takes 120 days to offer you that coverage?

If you did everything that you could, and the company still did not offer you coverage until 120 days later, you may indeed demand that the policy be honored, since it can be argued that they waited this long specifically to wait out the 120 days. If they do not, you should file a complaint with the US Dept. of Labor at 1-866-4-USA-DOL.
Customer: replied 3 years ago.

I THINK 18 MONTHS IS HOW LONG YOU CAN BE COVERED UNDER COBRA. YOU MUST FIRST BE OFFERRED IT. THANK YOU BUT I THINK I KNOW AS MUCH AS YOU ON THIS AND THAT IS NOT ENOUGH. I AM SURE YOUR EXPERTISE IS IN OTHER AREAS

Expert:  Ely replied 3 years ago.
I am sorry that we are not communicating on this well. I can close the question, or open this up for other experts. Which would you prefer?
Customer: replied 3 years ago.
IF THERE IS SOMEONE WHO IS KNOWLEDGABLE IN THIS AREA I COULD GREATLY USE SOME INFORMATION
Expert:  Ely replied 3 years ago.
Let me see if I can find a colleague who has special knowledge specifically to this. My apologies for any inconvenience.
Expert:  AlexiaEsq. replied 3 years ago.
Good morning,

I understand your dilemma. When should your employer or the Plan have provided you the option to hop on COBRA, once you resigned?

The employer has 30 days after the event occurs to provide notice to
the plan.

"COBRA Election Notice
After receiving a notice of a qualifying event, ... [resignation/termination is a qualifying event, and according to the DOL, that type of event, as opposed to divorce or other, is to be noticed to the plan by the Employer, not the Employee] the plan must provide the qualified beneficiaries with an election notice, which describes their rights to continuation coverage and how to make an election.
The election notice must be provided to the qualified beneficiaries within 14 days after the plan administrator receives the notice of a qualifying event."
LINK

So, from the time of termination/resignation, you should have received your notice 30+14 = 44 days later, at a maximum. I realize what this has cost you.

COBRA continuation coverage laws are administered by several
agencies. The Departments of Labor and the Treasury have
jurisdiction over private-sector group health plans. So you may want to contact the DOL to file a complaint. I have to say I am not impressed with their enforcement measures, but it is a start.

If you need further information, we are told to
call (toll free) 1-866-444-EBSA (3272) to reach the Employee
Benefits Security Administration regional office nearest you.

Good luck.

Because I help people like you here, for a living---this is not a hobby for me---I sincerely appreciate your abiding by the honor system with regard to Accepting answers, by Clicking your ACCEPT button now. Feel free to follow up after, if you need clarification. An Accept also assures that I can assist you again. A BONUS is a wonderful way to tell the expert her time and effort are appreciated. I wish you the best in your future.
Expert:  AlexiaEsq. replied 3 years ago.
Incidentally, it would appear that you should have been able to have COBRA from the date you lost your other coverage:

"The initial premium payment must be made within 45 days after the date of the COBRA election by the qualified beneficiary. Payment generally must cover the period of coverage from the date of COBRA election retroactive to the date of the loss of coverage due to the qualifying event. Premiums for successive periods of coverage are due on the date stated in the plan with a minimum 30-day grace period for payments. Payment is considered to be made on the date it is sent to the plan."


http://www.dol.gov/ebsa/faqs/faq_compliance_cobra.html

I know you only went back to March, since you were (I think) forced to buy private insurance to cover you and your family since you employer and/or plan dropped the ball to egregiously. Thus, I would think you could have a claim for the difference in price that you paid over what you would have paid for COBRA had it been properly offered, going back to November, if that is when you prior coverage ceased.

Good luck, it is very disturbing when this happens and I do hope they are held responsible.
--

Because I help people like you here, for a living---this is not a hobby for me---I sincerely appreciate your abiding by the honor system with regard to Accepting answers, by Clicking your ACCEPT button now. Feel free to follow up after, if you need clarification. An Accept also assures that I can assist you again. A BONUS is a wonderful way to tell the expert her time and effort are appreciated. I wish you the best in your future.
Customer: replied 3 years ago.

I have not purchased another plan but am without coverage until the COBRA is started. I had to pay full coverage for myself and dependents for NOV., DEC., JAN., and FEB which was in excess of 1200 per month. After they sent me the COBRA info I was allowed to drop my dependent coverage which now makes my premiums 630 per month. I feel I should have been allowed to do this in NOV. I am currently doing without some of my medications due to cost. One script is $259 per month. I cannot pay this for meds and send a insurance company $6000 also to reinstate my coverage. I am a respiratory patient and dependent on oxygen and Bi-pap machines plus many medications. I am at home sick as I have been without my meds. I also cannot go to the doctor now because I do not have coverage.

Expert:  AlexiaEsq. replied 3 years ago.
Hello again.

I have not purchased another plan but am without coverage until the COBRA is started. I had to pay full coverage for myself and dependents for NOV., DEC., JAN., and FEB which was in excess of 1200 per month. Why? If you didn't elect to continue the dependants?

After they sent me the COBRA info Isn't THAT when you made your election - of only yourself?? Rather than the dependants? I was allowed to drop my dependent coverage which now makes my premiums 630 per month. I feel I should have been allowed to do this in NOV. I agree, retro to Nov. I will look more but thus far I have not found such a rule -- but there is tons to read, so god knows.

I see this: "Each qualified beneficiary must be given an independent right to elect
continuation coverage. This means that when several individuals
(such as an employee, his or her spouse, and their dependent children)
become qualified beneficiaries due to the same qualifying event, each
individual can make a different choice.
The plan must allow the
covered employee or the covered employee’s spouse, however, to elect
continuation coverage on behalf of all of the other qualified
beneficiaries for the same qualifying event. A parent or legal guardian
of a qualified beneficiary must also be allowed to elect on behalf of a
minor child."


I am currently doing without some of my medications due to cost. One script is $259 per month. I cannot pay this for meds and send a insurance company $6000 also to reinstate my coverage. I am a respiratory patient and dependent on oxygen and Bi-pap machines plus many medications. I am at home sick as I have been without my meds. I also cannot go to the doctor now because I do not have coverage. I understand. The repercussion are significant.

This may not be of huge help, but you have 45 days before you need to pay premium after you elect:

"Qualified beneficiaries cannot be required to pay a premium in
connection with making the COBRA election. Plans must provide at
least 45 days after the election (that is the date the qualified
beneficiary mails the election form if using first-class mail), for
making an initial premium payment. If a qualified beneficiary fails to
make any payment before the end of the initial 45-day period, the plan
can terminate the qualified beneficiary’s COBRA rights."

I am confused though, because it would appear to me that you did not have to elect to keep your dependants on, in order to get back on, only to then discontinue them. Unless I am just not seeing it in this morass of code.
But here is how one employer explain it to its employees and I think this is accurate:

9. What if some family members want COBRA and other don’t want COBRA

Because each “qualified beneficiary” has an independent right to COBRA, qualified family members can make their own election and plan decisions. If someone in your family group doesn’t want COBRA but others do want COBRA, you will complete the Election Form appropriately. The Election Form has detailed instructions on it but, if you have any questions, please let us know.

24. What is the initial premium amount and how is it determined

It is determined by your final COBRA plan elections. Once you have made your elections on the Election Form, add up the monthly premium amount that is due. You will owe that amount for all past full months of coverage. Under the COBRA rules, the current month is due before the end of the 30 day grace period. For example, if your last full day of coverage was December 31st and COBRA is effective on January 1, you will owe for the months of January and February if you are making your election on March 15th. The March premium is due before the end of March’s 30 day grace period.


I think you have a case here. I realize the proper resolution may take longer than your health demands, and I do hope you have family you keep in touch with that can help during this time.

If you are disabled by your impairments, you may want to consider filing for Social Security Disability. When you do, since you indicate you have no more savings, or wherewithall to pay a doctor, you can also file for SSI, so that if you win, you will immediately get Medicaid upon winning, as opposed to the 2.5 year wait for Medicare.

I hope I have been of assistance beyond just answering your original question about the time requirements that have been violated. I see the time requirement violation and likely a forced payment for dedendant coverage that you did not want.

Good luck.

Because I help people like you here, for a living---this is not a hobby for me---I sincerely appreciate your abiding by the honor system with regard to Accepting answers, by Clicking your ACCEPT button now. Feel free to follow up after, if you need clarification. An Accept also assures that I can assist you again. A BONUS is a wonderful way to tell the expert her time and effort are appreciated. I wish you the best in your future.

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