Cobra Health Message Board

Subject: Re: Re: Former Employer's Notification Obligations

Comments:
: Mitch: : Sorry to hear that. Short answer: They should have notified you according to the rules of the plan. You are an active participant in the health plan, just like the other employed participants. : Long answer below: : Plan Modification : ERISA generally allows a plan sponsor to modify (or discontinue) health benefit plans so long as the procedure followed is consistent with the plan terms and ERISA. The plan administrator must inform participants of material modifications to the plan or changes to the information contained in the SPD by providing them a Summary of Material Modifications (SMM) or a revised SPD (29 U. S. C. 1024). : Unless the modification is a material reduction in covered services or benefits under a group health plan, the plan administrator must provide participants with an SMM within 210 days after the end of the plan year in which the change was adopted. A health plan administrator of a group health plan must inform plan participants of a material reduction in covered services or benefits within 60 days of adopting the modification. This 60-day rule does not apply if group health plan participants receive regular communications, including notice of plan modifications, from the plan administrator or plan sponsor at least every 90 days. A material reduction in covered services or benefits is any change in the plan or required SPD information that an average plan participant would consider important (e. g. , increases in premiums, deductibles, coinsurance, or copayments; a reduced service area; a change in benefit determination formulas that results in a reduction in benefits payable) (29 CFR 2520. 104b-3). : If you no longer have health insurance, or it's too expensive, I like e-health since they give you many options. Check out their rates at http://www.dpbolvw.net/click-3771903-10481703. But qualifying for those options is a different story. : Fred : : My former employer changed my health coverage plan which caused my COBRA premium to increase. I pay my premiums automatically to the insurance company but my last automatic premium payment did not cover the new premium and my medical services have been denied. I received no notification of any plan changes. : : Months ago I requested information from my former employer if they were even considering plan changes to notify me of anything, even tentative, so I can plan my budget and care needs. I received no response. In the past, while I was employed by them I received an election notice prior to any plan changes and had to select and sign a form indicating my choice. Now, nothing! : : What are the requirements for my former employer to notify me of any plan changes?

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