Question
What is the name of your state? CA
It's me again, for those who follow such things. I'm sorry if I overuse the forum, but another kink in the chain came up today.
We received the COBRA letter with instructions around 1/15, but it was dated 1/2. Today, we just got back our check from the insurance company saying the former employer terminated COBRA coverage through the company the former employer told us to go through on 1/1. Tomorrow I'm going to call the former employer.
I'm looking for guidance on how to handle the conversation. I'll start by explaining the situation and asking for their advice. However, I think that unless I get specific advice I'm going to start getting a little petulant and start demanding things. This is a national employer who has many employees in California. (My wife was employed with a subsidiary of a national insurance corporation! We're not talking mom and pop here.) They should know their duties. I would hate to have to resort to litigation to enforce my rights under COBRA, but we are getting close to deadlines.
What do you suggest? It's been more than 30 days since my wife was fired (although the insurance was cancelled only about 30 days ago) and we have not yet received a valid instruction as to how to access COBRA. The issue could conceivably result in hundreds of thousands of dollars in damages. Do I threaten lawsuit now? Do COBRA statutes have a payment of attorney fees involved?
I'm sorry if this doesn't make any sense. I bet those who answer will tend to be those who have helped in the past. As a reminder, my wife is the one who has Stage IV breast cancer. I'm writing without thinking much as I wish something would just go easy rather than hard.
Answer
I'm not sure where the 30 days is coming from. Or rather, which 30 days you are referring to.
The employer has up to 30 days to notify the COBRA administrator of the cancellation, who then has 14 days to notify her of her right to COBRA. So if it has been less than 30 days since the cancellation, they are still within legal limits to provide COBRA information.
I'm not yelling at you, but I would like to gently point out to you the part of my last post that reminds you that COBRA MUST be retroactive to the cancellation date. All claims incurred after the cancellation date can still be submitted for payment, and can be paid.
I also don't understand where the hundreds of thousands of damages are coming from, since the whole point of your last post was that you had added your wife to your insurance.
Answer
You're right of course. I posted too soon and without thinking. I will try to not do it again. It's just that it would be great to have things go easy and being able to blah blah blah with people who seem knowledgeable and willing to help can help. I'm not really at my best right now. (Even though this is not appropriate for now of course, I guess that's why a person who represents himself has a fool for a lawyer.)
Since I haven't been notified of coverage by my employer's insurance yet, I become worried that somthing goes wrong and we don't get covered at all. The insurances are different. My wife's coverage was complete for radiation, no co-pay, and fairly good for the formulary. My employer's coverage is pretty 80-20. The difference, just for this month, is thousands to tens of thousands of dollars. (Hard to estimate as we don't have a radiation bill in our hands.) But, now that I write that, I do believe there is an upper co-pay limit of $7,500 so, if covered, it will be not that big a deal.
We called an alternate number given us by the sorry-wrong-place letter and they hadn't received notification of a qualifying event as yet. Maybe they will have it tommorrow. (30 days) The letter we received from the company within the time required was not true. It was sent out after the day they knew the information was untrue. I thank God for the law so that my wife can be covered, but would love to get things done before too long. My credit card can only take so many $6,000 hits. More if the radiation bills start bouncing from the original insurance. Let alone the credit-card interest on that amount.
Sorry, sounds like I'm whining so I'll stop. Thank you for your help in refocusing me.
Answer
I didn't read the entire thread, but I have a suggestion. Instead of starting a new thread each time to you a have question, just add to the original thread. That way, you aren't assuming that we remember all of the details, and we don't have to go searching for any other threads to find out those details.
Answer
Thank you, that certainly makes a lot of sense. But rather than going back to the other thread, I'll use this one from now on.
To bring another problem up, in the other thread I mentioned going through my employer for coverage for my wife because of the uncertainty of communication with her ex-employer. We have not received word of coverage there (with my employer) as yet. The wording of the insurance contract agreement with my employer lists a qualifying event as being a reason why my wife could be added without a pre-existing condition clause (as long as she had creditable coverage for six months). I think that is HIPAA.
Today we finally got through to the company who immediately set us up with the COBRA notification after I reminded them of their duty. I barely had to threaten at all, I only had to ask for a supervisor who had specific knowledge of COBRA. My wife and I get to the website and follow the instructions to sign up, an I find on the confirmation page some statements including:
"I understand I will no longer be elegible for COBRA coverage if I become entitled to Medicare, or become covered under another group insurance paln that does not contain a limitation or exclusion due to preexisting condition."
Since my wife had coverage for the time required by my employer's insurance to be covered by pre-existing conditions, is she still eligible for coverage under COBRA? This seems a little different from some advice I received from posters in the previous thread. (Please see "Double Insurance" ) If not, I'll see if I can call my employer's insurance and see if she has been accepted yet. If so, I'll let things be. I either event I think I have to see an attorney who knows this stuff. Does anyone know what category I'd go looking? Elderlaw?
Funny thing is, I thought I was OK smart. I can read hard things and understand them. It's just that you've got to read all the hard things and understand them all. And then go through applying them a few times to get it right and to see how it all fits together.
Answer
If she becomes eligible for other insurance through her own employment, she is no longer eligible for COBRA.
She can still be eligible for COBRA even though she has access to coverage through you as your dependent.
However, if it is at all possible to have the COBRA coverage in place before you hear from your employer, that would be preferred.
Answer
Thank you for your comments. It does give me another area to research. I do appreciate your time.