Question
I live in Georgia.
My husband lost his job July 21st. He was then admitted into the hospital the 1nd week of August. They told me at the time that his insurance was still in effect. That there is a state law that says you have your insurance for 30 days after you loose your job. Well, he passed away. Now I'm getting bills, and blue cross is saying he didnt have coverage. That it was terminated the day he lost his job.
Who is right? I know you can get cobra and that is offered (by law) but he had only lost his job 2 weeks earlier so he hadnt even gotten the paperwork for the cobra at that time. So, does the insurance lapse between the job loss date and the date you get your cobra information???????
Or is the insurance company not telling me the truth? How do I find out?
Thanks,
Nancy
Answer
I'll have to take a quick look at it, but I strongly suspect that even if you are correct about the law saying they have to keep your insurance in effect for 30 days after termination, that law only applies if COBRA does NOT apply.
I can tell you without checking, that legally an employer MAY cancel coverage on the last day of employment, and reinstate it ONLY when they actually have your first check for COBRA payment in hand.
I don't have time right this minute to look this up for you, but I'll get back to you later in the day or tomorrow.
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I do appreciate it!
I'm sure if theres an option where the employer can do that.. they did, they were about the cheapest company around.
Thanks for looking into it for me
Nancy
Answer
Nancy, here's what I have so far. I am not finished yet.
I cannot find ANYTHING to confirm that there is a state law in Georgia requiring that insurance be continued for 30 days after the termination of employment. Such laws were fairly common in the days before COBRA, but once COBRA went into effect many states repealed them. I have checked the GA state website for employment laws, which refered to COBRA but not to any state equivalent such as you describe (it did describe a state-enforced right to continue coverage at your own expense), and I've checked that Georgia Code in the insurance section. Since these laws existed in many states for a number of years, a lot of people don't realize that COBRA supercedes them and that they no longer exist.
I'm not (yet) saying that you're wrong. So far, I'm saying that I can't find confirmation. If you have something more, such as a statute number or a case law, please post it for me. I have no client meetings tomorrow and other than going out to vote and running one errand that will take about an hour and a half, I'll in my office most of the day and will be happy to check it for you.
In the meantime, an employer legally has 30 days to notify their administrator of the need for COBRA, and the administrator has 14 days to send the information. So it can legally take up to 44 days after termination (voluntary or involuntary, doesn't matter) before you receive your COBRA information.
You have 60 days in which to decide whether or not to elect COBRA, and from the day you elect it (whether you elect it on day 1 or day 60) you have 45 days to send in your check. Your first check MUST be for all the time from the last day of coverage (which may or may not be the last day of employment - more on that later).
The employer legally can, and it is very, VERY common for them to do so, cancel coverage until they actually have your check in their hand. The reason for this is fairly direct; if they were required to keep your insurance active until you decided whether or not to elect COBRA, what would stop an unscrupulous employee from racking up thousands of dollars worth of medical bills and then not paying the COBRA premiums? Even if the coverage was immediately cancelled, the insurance carrier would still be out the costs of the bills (and that can directly impact next year's premiums) and the employer would still be out the cost of the premiums they'd already paid. While this might not be a major problem if you work for IBM or Microsoft, for a small employer this can be a major financial impact.
Depending on how the insurance contract is written, coverage generally ends either on the last day of employment, or the last day of the month in which coverage ends. In my experience, it's about a 50-50 split which is more common. From the dates you have provided, my guess is that your husband's policy was of the last-day-of-the-month-following-termination type. This means that any bills up to, but not including, August 1 would be covered. This would explain why you were initally told that coverage was still in effect but later that it wasn't. Of course, I could be wrong and someone somewhere made an administrative error. I'd have to see the insurance contract to be certain. Obviously, I can't do that . Do you have a copy of the insurance plan? If so, can you take a look for me and see what it says about termination of coverage? If you don't understand it, post it word for word so I can see exactly what it says.
While I'm about 99% sure that you can still maintain COBRA for yourself after your husband's death, I'm going to have to do some checking as to whether or not that would include bills for him before his death, under the circumstances. What was the date of his death? And what were the conditions under which he lost his job? That's *probably* not relevant, but I can think of one or two situations in which it might be.
BTW, since I seem to have neglected to say so before, I'm very sorry for the loss of your husband.
I have a friend who is an employment attorney in Atlanta. I'm going to run your situation past him and see what he has to say. The only thing is, he isn't always available to answer questions immediately and there's no guarantee when he'll get the message. Also, I'm on vacation all next week; if I haven't found an answer for you by Friday, it'll be Monday the 15th before you hear back from me. While I might, if it rains or something, check in and answer any questions that I know the answer to off the top of my head, I won't be taking any research questions.
Let's see what we can find tomorrow.
Answer
HI,
Ive been doing some searching and I cannot find any information on it. My husband had blue cross and blue shield of Georgia. It was an HMO. I do not have any paperwork that goes into the termination rights. It only says that they will be offered cobra, but doesnt state anything about what happens in the mean time.
I am thinking you are going to be right and that I'm going to be stuck with the bills. I am hoping the hospital wont hold me liable for them. I was told something about the estate being liable for it, but if the estate had no money (which it doesn't) then the hospital will waive the bills? I'm not sure if this is true.
I also read somewhere that unless I signed something saying I'd pay the bills in the event of his death, that I am not responsible (and I didn't). I sure hope that is true also.
This whole thing is a long and depressing story and I wont bore you with the details but the hospital is liable for his death and I'm in the process of finding a good malpratice attorney anyway. So, I really don't want to have to pay the hospital bills for something that should have never happened in the first place.
I do appreciate all the time you are spending on this. Its so very nice of you! You don't often find people that willing to help anymore!
I wish I could give you more information to go on but I really don't know what else to tell you.
Thanks very much.
Nancy
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I hate to pester you, I know you're under a lot of strain, but before I can carry this much further I really need the date of his death and the circumstances under which he lost his job. Can you give me that much, and then I'll let you know if I need anything more?
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Well he died on August 14th,(the death certificate says the 15th because we didnt find the body until after midnight) the day he was released from the hospital (his death was from suicide which makes things even more messy and harder to deal with).
He lost his job on July 21st. He was terminated for making an error on the job (he was a chemical mixer) and the error cost the company money...
I hope this helps some.
Nancy
Answer
Okay, that tells me what I need to know to get started. I'll get back to you if it turns out I need additional information, but this will give me enough to go on for now.
It'll be tomorrow before I post again. See you then.
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Nancy, I haven't forgotten you; I haven't heard from my friend in Atlanta yet. Have patience with me; I'll be back as soon as I have something for you.
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Nancy, a couple more questions:
1.) Did you AT ANY TIME, regardless of whether it was before or after your husband's death, receive the information about COBRA?
2.) How many employees did your husband's employer have? If you don't know the exact answer, was it over or under 20?
3.) How long, before his termination, had your husband been covered under the health plan?
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Hi,
Well lets see .. no on the cobra.
Yes there are more than 20 employee's there that I know of.
And he was covered under that plan for maybe 1 1/2 yrs .. the company he worked for was sold off. He worked for the company for 4 yrs but it was 1 1/2 yrs ago that it was sold.
I hope this helps.
Nancy
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Okay, Nancy, I think we've got this covered.
You are mistaken about there being a law that they have to continue to cover you for 30 days after termination. (I did hear back from my friend this afternoon.) Either there was such a law prior to COBRA, or you are confusing a previous company's policy with law. Either is possible; both are common. As I said, many states did at one time have such laws, and many, many people mistake company policy for law, even people who should know better, and you would have no reason to know better.
However, since there were more than 20 employees COBRA applies.
Since he was covered for more than 6 months, GA state law regarding continuation applies.
Understand that under either law, the coverage is continued at your expense. Also, the GA law does not apply if the employee is terminated for cause. It's possible that your husband's employer considered that he was termed for cause, and that the state law did not apply.
COBRA, however, should have applied. COBRA can ONLY be denied in cases of gross misconduct, and I am having a hard time imagining how the kind of error you describe could have been considered gross misconduct. While that is not defined in the regs, the standard is VERY high. About the only way I can think of that the company could have denied COBRA, would be if they had a valid reason to believe that he DELIBERATELY made the error.
It is possible that the company believed that after your husband's death, COBRA no longer applied and they did not need to offer it to you. They would be mistaken. In fact, not only was COBRA available because of his termination, but his death was another COBRA triggering event.
I think we've about reached the limit of what can be handled on a message board. But what you need to do now, is contact the US DOL. They are the regulatory agency handling COBRA issues. Explain to them what happened and they will walk you through how to file a complaint.
You might also want to have a consultation with an attorney (many give free or low cost consultations), preferably one who is versed in employment law.
Good luck, and feel free to come back if you have additional questions. In fact, please do keep me posted.
Answer
HI,
Thanks so much for all that info!! IT sure helps!
(I didnt get an email saying you had posted, that is why I am just not getting back to this post)
I think I will definatley check into this. I need to talk to attorneys about so many things, I'll just add this one to the list. Hopefully they will know how to handle this! But, I will also check out the US DOL site!
Thanks again so much for looking into this for me! It really helps alot!!
Nancy