Question
What is the name of your state? Tennessee
I resigned my position and my last day at work was 11/29. This employer states that coverage ends on the last day of the month, so my coverage ended 11/30 at midnight. On 12/07 I received a letter about my COBRA options dated 12/03. I went to the pharmacy to pick up some prescriptions (assuming that my coverage wouldn't be canelled yet and I was going to continue it through COBRA). I was informed that my employer had knocked me and my family out of the system at midnight on 11/30- gosh they worked fast. Kind of ironic that I'm a RN and this is a health care employer.
I was waiting to see what they did on my last paycheck since our portion of health insurance premiums were paid a month ahead, and had no idea I would be bumped out so quickly. I knew I would be retroactive, but knew that if there was an emergency or something this could cause problems as we would not show active in the system. I called the COBRA person at the company and was very nice (or tried to be). I told her I was surprised that she went ahead and took us all out so quickly and she made some smart remark. I told her of my intentions to continue with coverage and that I would be sending payment and paperwork in.
12/13 I sent in a money order (didn't want to create more reason for them to delay) for December and January (It is $515 a month. I resigned because of some family issues and Christmas is upon us). It wasn't an easy hit financially, but we'll get by. 12/15 I called to see if she has received it. Once again she is curt with me and informs me that mail runs slowly this time of year. I ask her what is involved in getting us back in the system and she says it normally takes 24 hours once she receives payment. I have some health problems and am needing to get some prescriptions filled. She informs me I can pay full price and then submit some forms to get reimbursement from the insurance company later. Kind or irritates me.
12/20 I receive the signature card back in the mail signed for on 12/18. I also receive a letter from her verifying that she received 2 month's worth of premiums. 12/21 I call BCBS and we are still inactive in the system. 12/22 I call her and leave a message and receive no return phone call. Everything shuts down until Tuesday.
12/26 I call the dragon lady once again and inform her that I called BCBS and they have not received notification from her yet. She says to me; "We don't notify them, I just have to push a button on my computer." So, while I'm on the phone with her it takes her 20 seconds to make us active in the system but it will take at least 24 hours for Blue Cross to be updated and probably 48 hours for the prescription side to update.
It took her less than 24 hours to knock us out of the system but took her several weeks even AFTER she had our money to re-activate us.
My question is: Was she allowed to de-activate us like she did and was she allowed to take so long to re-activate us?
What is it with people like this? She is literally messing with people's lives here. The company is giving me nothing. I am paying what they are paying- actually I'm paying a 2% "fee" for her wonderful service.
Is there anything that was done illegally here or are they just jerks?
Thanks,
Ann
Answer
It is entirely legal, and quite common, for coverage to be cancelled on the effective day and not reinstated until they have received your check. No law specifies how long they have to do so once the check is received. COBRA coverage MUST be retroactive to the day of cancellation so you're not going to lose any benefits no matter how long it takes them. The worst that can happen is that you have to ask for a bill to be resubmitted.
To be perfectly frank with you, while it may only take her 20 seconds to push a button, this time of year I can guarantee you that this is far from the only thing she has to do. This time of year is literally hell for HR personnel and pushing that button is not her first priority. Given that your coverage will reinstate on exactly the same day no matter when she does it, whereas some of the other stuff she has to do at this time of year is quite time sensitive, I can see why it might go to the bottom of the priority pile. I hesitate to even qualify them as "jerks" having lived through this process more than once. I don't think I can express to you in this kind of forum how much is going on in the HR/Benefits department at year end.
For the record, once she does push it (and it's a bit more complicated than that, though not much), BCBS has that information instantaneously (I am quite familiar with the process involved having "pushed the button" on numerous occasions myself); there is no 48 or even 24 hour processing time. I've worked on the exact software she's talking about. However, if you are using the mail order Rx feature that comes with some BCBS plans, that is through a different carrier working with BCBS and there can be a 24 hour batching process.
As I said above, COBRA must, by law, reinstate to the last day of coverage. The worst that can happen is that a bill has to be resubmitted for payment with you being reimbursed for a payment you made up front. A little inconvenient? Sure. Illegal? Not hardly.
Answer
I do know that it took BCBS's Caremark system an extra 2 days to update my reactive status, because I needed prescriptions filled and I kept calling to see when I could do this without paying over $600 out of pocket that it would cost me otherwise (I would have been reimbursed, but who knows what I would have had to have gone through and how long that would have taken). I just spend over $1,000 on my premiums.
I am sure the COBRA coordinator at the company does have other duties that she does that I do not see. However, she had the time to write and send me a letter on 12/19 stating that she received my premium but did not seem to have time to take the 20 seconds to re-active me and my family. And yes, it did take 20 seconds because when I finally reached her and demanded to be put on hold while she did it, it took 20 seconds. It was almost as if she was doing me a favor. People like that do not need to be in positions like that. If I could buy individual health insurance, I would. I have before for me and my son but my 11 year old daughter has had brain surgery, has platinum coils in her head for the largest arteriovenous malformation they had ever seen, and we spent from March to July in 4 hospitals in 3 states for RSD. No individual plan will touch her. I have been through just about everything anyone can go thorugh with health insurance. This person needs to realize she is messing with people's lives- literally. It is not a joke and not a way for her to exert power over people.
Answer
I am not unsympathetic to your situation. But until you have sat in the seat of someone in that position, please consider that you do not know everything about what they have to do and how they have to order their priorities.
First of all, it is not a 20 second transaction. That was your opinion on the matter. It's more like a four minute transaction from start to finish. I went along with your assumption in my first post rather than argue the point, but your insistance that it is a 20 second transaction is simply incorrect. It involves logging remotely directly into BCBS's software, which is a several minute process in itself. For that matter, it is common practice to wait until there are several such transactions needing to be done before doing so. If it only took twenty seconds when you called her, then I assure you she was already logged in at the time. There is no possible way she could do it in 20 seconds otherwise (which means it would probably have been done at that time whether you called or not). Keep in mind, I am not talking out of my hat; I have done many a transaction under the BCBS software and am extremely familiar with the length of time it takes.
Answer
All right, it took four minutes and not 20 seconds for her to complete the process of re-activating us in the system- whatever. The COBRA person at the company seemed to have no problem finding the time to do this when she took us out of the system. She also seemed to be able to find the time to draft a letter to me stating that she had received my premiums for two months and send it to me within a day of receiving my premiums however, she couldn't find those four minutes to reactivate us in the system for six working days and after multiple calls from me? I'm not trying to argue, but was merely looking for some validation that what this employee did was ethically wrong. It is obvious by her other actions that she was not too busy to take four minutes to do one task that meant a great deal to one family, it was just a matter of (I believe) something she had control of and so she was going to use her "power." This is why we have to have so many seemingly silly laws and rules about allowable timeframes.
I have had experience with COBRA in the past. My husband was an Ironworker in the union for 30 years until his knees literally wore out and were bone to bone. The orthopedic surgoen told him he needed both knees replaced but had to retire early because the new knees couldn't take the pressure of the job. Knowing his surgery was coming up and I would be tied up with him, I paid several months of COBRA ahead. He had complications during surgery (2001) and was in intinsive care at the end of the month. At his bedside at 4:30 on a Friday afternoon I received a call from the billing department of the the hospital stating that his insurance was going dead at midnight that night and after that he would have none. I of course knew that this was not true because I had made sure to pay ahead but that since we were considered on a month-to-month it probably showed this every month. Of course the union office was closed by this time until Monday, my husband was in pretty bad shape (he coded twice that day), and the billing department wanted me to come up with $5,000 "good faith" money.
The whole system is a mess. I have been a RN for 12 years and can tell you that there is a major difference in the type of care people receive based upon their insurance. I can also tell you that it makes a difference to be an involved patient or have an advocate who will be involved for you. Until our policy-makers have been in some of these situations, I don't think that much will change. That's my soap box.
Ann
Answer
Since I have been in the position she has been in, I can easily understand how the priorities were offered. It does not require access to someone else's software to write a letter.
However, it's also very clear to me that nothing I am going to say will persuade you that there could be any possible reason for the ordering of the priorities than to deliberately and maliciously make trouble for you. Obviously you believe yourself to be important enough to this woman so that she would risk her job, or at the least a poor review, just for the pleasure of showing her so-called power over you.
I started out at least sympathetic to your situation, but you've talked me out of it. Since you clearly believe that everyone should manage their job in the way that will be most convenient to you, regardless of its affect on everything else on their plate, as far as I'm concerned you're on your own from this moment.
Answer
I certainly don't expect someone to manage their job in the way that it would be most convenient to me, but I do believe that when you're dealing with something as important as a family's health insurance- that should be a priority. As a nurse, I have many responsibilities. Many involve direct patient care and many involve dealing with insurance companies, paperwork, employer issues, etc. All are important parts of my job and there are ramifications for all if I am remiss in completing any part. But, there is no question where my first priority lies- it is with my patients and their families. That is what gets taken care of first. I don't think the COBRA person's job at the company should be any different. That's not asking for the world to revolve around me. That is just treating others with respect and basic humanity.
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But you are not the only employee she is responsible for. Are you saying that your COBRA is more important than setting new employees up to be paid and receive their benefits, other employee's benefit issues, handling open enrollment, etc.?
Answer
No I'm not saying that at all. I know the size of this company and I know what the work load was on this person. All I have been saying from my first post was that the person handling my COBRA had the time to deactivate my family in the system right away. She had the time to draft and send a letter as soon as she received my premiums, but it took many days for her to reactivate us in the system and this should not have happened- period. We are all busy. I know what busy is. She had an attitude with me from the first time that I called her and that never changed. It took her longer to write the letter to me than it did to reactivate me in the system. That is plain wrong. That is messing with people's lives- literally. I am done with this post. This has become a silly argument. I know what should have been done. I was not asking for treament that I would not have expected myself to extend to others if I was in her position.
Answer
I agree; this post is done. You are never going to see any point of view other than your own, and you are never going to understand that just because she had time to write a letter on one day does not mean that on another day she had the time to do the reactivation immediately. Contrary to what you evidently believe, it's quite possible on different days to have different job loads.