Never received Cobra Packet

[LoneWolf1038]

What is the name of your state? South Carolina, but the corporate office is in Rhode Island.

Hi. This is my first post, and I am hoping you can help me.

I worked for a company for 8 years and then became disabled. My last day of work was Sept. 9, 2006. I am currently on LTD. I was paying for my health insurance after my disability through my employer for 6 months, at which time I was to be covered under Cobra.

Sure enough, my insurance terminated on March 9, 2007. I never received a Cobra packet. They used a third party company to send them, and the company that they used no longer handles it for them.

I called the 3rd party co, and they said they sent a packet out on March 15th.....but I never received it.

I have made NUMEROUS requests to my employer about getting another packet sent to me. Now they are telling me that because I did not return my enrollment elections within the 60 days, I can not get another packet. How was I supposed to send back something I never received in the first place?! I never got a packet to begin with....and now they are basically saying, "tough..."

That is NOT fair that it is not MY fault I didn't get the packet. I have NO medical coverage, no prescription coverage, have had to cancel a surgery, and all they can come up with is, "well, you waited too long".????

This can't be right! I am being penalized for something I had NO control over!!! What can I do?!

Thanks in advance for your help.What is the name of your state?What is the name of your state?

[TIMMAAYY]

Losing your COBRA plan may have been a blessing, depending on it's cost to you.

Here is a link to a guide for the SCHIP program and COBRA/HIPAA eligibility for South Carolina. From the sounds of it, since you have exhausted COBRA, you should be HIPAA eligible for the SCHIP program.

[url]http://www.healthinsuranceinfo.net/sc00.html[/url]

For more information you can call them at 800-868-2500 x 42757

If your former employer didn't get you the packet in time to renew it, probably doesn't matter a whole lot at this point. The important thing is to get coverage now.

Once you are covered again you may want to have an attorney check into it for you, but good luck with that. It's going to be your word against theirs; not an easy one. I can't find anything on SCHIP for your state online, but I am still looking. If I find any I'll post them for you.

Best bet is to call them yourself and see what they would be for you. Online information isn't always updated in a timely manner.

EDIT

Here is a link to the plan infor and rates.

[url]https://www.doi.sc.gov/Eng/Public/Consumer/Consumer.aspx#Publications[/url]
At the bottom of that link is a heading for SCHIP program information, with plan info and rates based on your gender and age.

Also, if you are disabled and unable to work, you may be eligible for Medicare, but you would have to wait until you have been disabled for 24 months.

[cbg]

Their obligation is to send it. They are not responsible for confirming that it was received.

IF they have proof that it was sent to your last known address, they have met their responsibility under the law.

[LoneWolf1038]

Originally Posted by cbg

Their obligation is to send it. They are not responsible for confirming that it was received.

IF they have proof that it was sent to your last known address, they have met their responsibility under the law.

Thank you for your response. I am thinking the "operative" word here is "proof". What consitutes "proof"? As Timmaayy said, it is my word against theirs, is that their proof? Their "word" that they sent it?

This morning my employer's LOA dept called me and said that since I did not respond in the appropriate time limit to enroll blah...blah...blah. She suggested I call the administrator that handles Cobra (which no longer handles it). I told her I DID call them, and that they said they sent it, they don't handle Cobra anymore, and that they won't say much more. She said that I had 45 days to return the form. I reiterated AGAIN...that I can NOT return something I never received. When I said that, she paused and said she will call me right back. I'm not sure if that's a good sign or a bad sign, but it's more of a stir than I have had from anyone in the past few months on this.

[cbg]

Many, many employers send COBRA information by some form of traceable mail. I'm not saying your employer CAN prove it - I don't know if they can or not. That's why I put IF in big letters.

But it's by no means always the employer's word against the employee's. Sometimes it is, but a smart employer can find any number of ways to prove that COBRA information has been sent. I, personally, send COBRA information by certified mail.

[TIMMAAYY]

The burden of proof is always on the one making the claim. Prove they DIDN'T send it. That's the hard part. You not having it in your possession will hardly cover that claim. If nothing else their HR should have a personnel file of when the information was sent, hopefully with a copy of the letter.

Unless you CAN prove they didn't send it, it's a battle of you versus them with nothing more than words. Hopefully, they DID mess up and will correct it for you.

[LoneWolf1038]

Well, my not receiving the packet then is NOT "proof". Of course, I asked (on my first request for a new packet) if they could send me the packet certified or some other way that would require "proof" that I had to sign for it. They said that is HIGHLY irregular, that they usually just send it regular mail.

My last post said that the LOA dept was going to call me back. They called later that day and said they had contacted SCHIP, and told them to send me another packet, but that the only problem I would have is that when I got it, I would have to pay the premium retro-active back to March 9th. I told her I figured that....but that I needed the insurance, so I would figure out a way to pay the back premiums. I was happy...well, broke, but happy.

A little later, she called back AGAIN, and said that SCHIP said they had mailed me a letter back in March saying that THEY were the new administrators. She told me the date (3-21) and the address SCHIP said they had sent it to. The address was in MASS!!! I live in SC! The woman from LOA suggested I call SCHIP and have them correct my address. When I called SCHIP to do that, we found out whoever the LOA dept talked to gave her the address for someone else! They said they had a spreadsheet from the previous administrator showing they had sent a packet to me 3-19. She went on to say that since I did not respond....blah, blah..... I told her I did NOT reveive the packet!!! She said she would make a note of that and send it back up to the processor, and they would contact me Monday or Tuesday.

That is where it stands right now. I guess my company has approved the request to send me a new one.....but now SCHIP is balking. Can they do that if the employer tells them to send a new packet???? After all, isn't it up to my employer?

[cbg]

The administrator is the one responsible for handling all COBRA issues, so yes, they can.