Cobra Health Message Board

Subject: Re: Re: Timing of notification of COBRA plan change and my cancellation rights

Comments:
: Lynn : : ERISA requires the sponsor of a group health care plan subject to its provisions to inform plan participants, including any former employees eligible for plan benefits, of (1) a material reduction in covered services or benefits within 60 days of adopting the change and (2) any other material modification to the plan within 210 days of adoption. : : Also some state laws often require an employer providing group health insurance coverage for its employees, when substituting another insurance policy, to give each insured employee notice of the substitution a certain number of days before the effective date of the change. : : You said you got the required notice within 18 days of the change. It may really seem unfair and the economy makes it even worse. But the company most likley obeyed the COBRA or Mini-COBRA notice requirements either State or Federal. : : You mentioned "refills for drugs." Know that if you cancel your COBRA, even the high deductible plan, you may not be able to get new coverage. Would it be an option for you to find out if the health insurance carrier offers conversion policies once COBRA expires (of course, a better plan)? : : One thing that smells: You have 90 days to elect to change your COBRA plan. Like the other plan partipants, you have a right to choose to enroll or unenroll in the catastrophic plan. You should not have to pay for something that isn't what you were getting. Did you get a cancelation notice with the initial COBRA enrollment paperwork or the notice of COBRA plan change? Instead of calling, I would send that in certified. : : You might have a "small" claim, but COBRA issues have to be litigated in Federal Court. Unless you are willing to hire a lawyer, I do not know if you will find an ERISA lawyer that will take a $3,000 case on contingency. The damages are just not there. To put in perspective, some people have open heart surgury or give birth to a premature baby wiithout being offered COBRA. And as a result, they lose their home, credit rating, etc. Those are damages a lawyer would prefer to litigate. : : Have you contacted the IRS about this dispute? The Government is really inundated with request because everyone is losing their jobs, employers are reducing coverage etc. I wish I could say your case was a rare one. : : Fred : : : I have been on COBRA for 8 months. January 18th I was officially notified that my former employer had changed their plan effective January 1st. The plan change is substantial from small co-pays to a high deductible plan. I must first pay $3,000 out of pocket for all medical expenses, doctor visits, prescriptions before there is any coverage. : : Not knowing this my family used the plan in January and were actually charged the old co-pays. When I spoke with the health care provider on the 18th, they said I was still covered under my old plan but that if the employer had changed the plan my coverage would be changed effective January 1st also. : : Legally this does not seem proper. I had paid for my January coverage in December under the assumption that my plan had not changed. : : I called January 22nd and asked them to cancel the plan effective January 1st and to return my premium. But they said this could not be done because they had paid on claims for that month. The funny thing is that the payments they made were under the old plan's guidelines. Because in fact under the new high deductible plan they would have made no payments. I assume they plan to use my premium to make themselves whole on the payments they had made to the doctors and prescriptions under the old plan guidelines. Then attempt to bill me for the balances because I have not met the $3,000 deductible. Along with this they will also include the charge for the new plan's January premium. : : Also if I had known of this change we would not have seen the eye doctor, gynecologist, and allergist in January. : : What can I do? If I did not have coverage for January I would be better off. I would still need to pay full amounts for all medical expenses and would save by not paying the January premium. : : The continued COBRA incentive will not help many in my situation. Who can come up with $3,000 when unemployed? Just hoping for the best that my family does not become sick and that our doctors will write refills for drugs that maybe the drug companies will help us with. : : Thank you for suggestions and help with this question. :

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