COBRA hassles

[free4now]

I left work more than a month ago with a severance package, and my 60 days severance health insurance period is running out. So I've got to get enrolled in the COBRA program soon.

The small company that adminsters the COBRA program for my former employer is incredibly unreliable. I had to buy COBRA coverage when I took a sabbatical a year ago and there were constant delays getting my health coverage activated; it wasn't until I was almost done with the 10 month sabbatical that my health coverage was actually activated (retroactively).

Now this time I learn that they won't even send me the enrollment package for COBRA until a few weeks after my 60 day coverage lapses. Then they say I have 60 days from the lapse date to retroactively enroll.

Has anyone else had this experience... is it too much to ask to register before my coverage lapses? It seems like a bad situation... if for some reason the COBRA enrollment doesn't work out then for HIPAA purposes I'm no longer covered due to the gaps in coverage.

 

[Ed_The_Gypsy]

Try talking with your state insurance commissioner. Then go back to your insurance company.

 

[tryan]

One of my people moved to part time (a few years back) and needed COBRA. A week after the switch her DH landed in the hospital and needed his appendix removed. They were told they had NO coverage! And report they were treated like homeless ... ushered out the door immediatley after surgery.

So there they are ... his wound is a mess; needs bandages changed. They call a home nurse; took 3 before one would come (still " no coverage"). They had to pay $$ up front.

Eventually COBRA reimbursed all payments; but this left some real scares (literally) on these people.

 

[2B]

Now this time I learn that they won't even send me the enrollment package for COBRA until a few weeks after my 60 day coverage lapses.  Then they say I have 60 days from the lapse date to retroactively enroll.

This smells. Everything I've ever seen says you have 60 days to accept COBRA from the time you leave a company. Your description says you will not be eligible for COBRA when they finally send you the paperwork.

Someone said earlier to check with your state's insurance commissioner. I second that. Do it quick. You may be dealing with either crooks or idiots.

 

[tryan]

Everything I've ever seen says you have 60 days to accept COBRA from the time you leave a company.

When I left megacorp in MA, I was told we had 60 days from the time you recieve the enrollment paperwork. The HR rep twice said if they delay the paperwork you have more time.

But he also said I'ld get my first severance check 2 weeks after my departure ... and this didn't happen.

 

[2B]

I have extensive experience leaving companies. On my checkout day, I have always been given a COBRA packet. I always sent it in as "accepting," but I always had new insurance before the first payment was required (60 days). So, I never paid for it. If something serious would have happened I would have mailed the payment in ASAP. DW and children always knew where the COBRA payment was sitting and ready to be mailed.

 

[poboy]

http://www.dol.gov/ebsa/newsroom/fs052803.html

This might be a starting point.  There is a phone number at bottom of page.  

 

[Outtahere]

I agree with calling the insurance commissioner and also call the insurance carrier your company uses and get the information from them. Something isn't right there. We are required to send the person out with a Cobra letter and they have 60 days to decide. What most companies will do is terminate you as soon as you leave, if you want Cobra they will reinstate you, if that's what they are doing tell them you want it now..don't give them the chance to do that. Give them payment for it too.

 

[Martha]

I believe your 60 day time period runs from the time the enrollment materials are mailed to you. However, there are deadlines within which those materials must be sent to you and it looks like the company is not meeting those deadlines. I would put everything you do to address this in writing and keep a copy.

 

[lazygood4nothinbum]

even though i was paying premiums to cobra administrator each time i'd go to a doctor (mostly just allergy shots), eye exam or dentist i was told i didn't have insurance.

numerous calls to cobra and the insurance companies just kept me stymied. finally i called the human resources department of my former employer and the problem was fixed that day.

 

[free4now]

I spoke with someone from the insurance comissioner's office who referred me to the local Department of Labor EBSA office. They were very helpful, and basically said that I'm okay here.

He said that after my termination of benefits (not necessarily employment termination date), the company has 30 days to notify the plan administrator, and then the plan administrator has 14 days to send me the enrollment package. So they legally could wait 44 days after my benefits termination to send the enrollment package.

And then I have 60 days to enroll, and 45 days from the time I enroll to send in my payment. So if everyone stretched everything out it could theoretically be almost 5 months (almost 7 months after my Mar 1 termination) before I sent my payment in and still I would have coverage retroactive to the date that my benefits were terminated. And I would still be considered to have gapless coverage for HIPAA purposes.

But of course the wrinkle is that during all that time if I go to a health provider for service they might say take a hike since the insurance company hasn't started the coverage. Theoretically I could convince the provider that I actually am covered under COBRA even though the insurance company says no, but practically that seems unlikely. There doesn't seem to be any way to force the insurance company to consider you covered until a little while after the payment is sent.

So it looks like I have to be careful not to injure myself for a little while.

 

[2B]

What you'd have with COBRA would be a high deductible policy for free. You'd only pay unless you had a serious injury or illness until you got other insurance.

Of course, if you are planning to stay on COBRA until it runs out there isn't any reason not to start paying right away.

 

[youbet]

So it looks like I have to be careful not to injure myself for a little while.

Unless you're talking big bux, you can always pay and file a claim later when everything is in place.

 

[free4now]

Unless you're talking big bux, you can always pay and file a claim later when everything is in place. 

Yep, but there are so many gotchas to that process that I hate to go there. Often the health care provider will adjust the procedures or at least the billing of the procedures to fit it into your coverage. If you can't show them your coverage at the time of service you run the risk of being billed for procedures that are unreimbursable.

 

[youbet]

Your cobra coverage will be the same as your active employee coverage. At least that is what the law says.

 

[rs0460a]

Another kind of "Cobra Hassle"  8)

http://www.fordmuscle.com/blog/ford-recalls-2003-2004-cobras/11291

 

[farmerEd]

I have extensive experience leaving companies.  On my checkout day, I have always been given a COBRA packet.  I always sent it in as "accepting," but I always had new insurance before the first payment was required (60 days).  So, I never paid for it.  If something serious would have happened I would have mailed the payment in ASAP.  DW and children always knew where the COBRA payment was sitting and ready to be mailed.

And the company never came after you for the payment? I would assume that if you accepted COBRA, your previous employer then would have been required to make the premium payment on your behalf (like all employees) and then they would collect from you, so I am suprised they didn't try to get you to pay up...

Also, is it really possible to "risk it" for 45 days, and if you are injured, then sign up for COBRA? I also assumed that if you had services performed, before you acctually signed on for COBRA that they wouldn't retroactively cover you...no?

 

[2B]

And the company never came after you for the payment? I would assume that if you accepted COBRA, your previous employer then would have been required to make the premium payment on your behalf (like all employees) and then they would collect from you, so I am suprised they didn't try to get you to pay up...

Also, is it really possible to "risk it" for 45 days, and if you are injured, then sign up for COBRA? I also assumed that if you had services performed, before you acctually signed on for COBRA that they wouldn't retroactively cover you...no?

Nope. Never did.

Yes. The option period is yours. If you get hurt during it, you can exercise your option. COBRA is great except it's too short. Now if it lasted about 15 years that would be great.

 

[Ed_The_Gypsy]

I did the same as 2B once, by accident. I paid them a check--which they never cashed. After I got my next job, I cancelled the check.

 

[tryan]

Also, is it really possible to "risk it" for 45 days, and if you are injured, then sign up for COBRA? I also assumed that if you had services performed, before you acctually signed on for COBRA that they wouldn't retroactively cover you...no?

Yup, during my exit interview the HR also said to pay cash to the Drs. THEN if you decide to sign onto COBRA - apply for reimbursements (if/when the COBRA premium has been exceeded by the bills). Even said you can "cut the first payment check from the hospital" ... but it's a retroactive payment for the entire delay.

Never used COBRA though ... BCBS was lined up.