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Getting the 11 month extension on my Cobra

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I_cant_fnd_help

Junior Member
What is the name of your state? Kansas

I have a physician that KNOWS I am Permanently Disabled due to 3) unsuccesful surgeries to my right foot that cause moderate to extreme pain daily from "stump neuromas".

His administrative assistant (nurse) doesn't care for me and I feel the same.

I ran across somewhere googling this that I needed some letter stating I was Permanently Disabled and could not work in my field for at least a year.

I send her a letter. She calls me back, say: "I don't know what you are talking about, and we are not your welfare ticket", and probably threw it in the trash. :mad:

I have GOT to come to come up with some kind of official documentation, from a website of a brochure that tells that B8CH what exactly to do.

I am getting close to desperate for Help!
This thing runs out at the end of August 07.

If anyone has an answer: I would certainly appreciate that: Greatly!

Thanks in advance for any suggestions or advice!

Steve J.
Live in Kansas City: in a Kansas suburb
The Employer (WAY over 500 employees, and 8 branches) is in MissouriWhat is the name of your state?
 


cbg

I'm a Northern Girl
When did your COBRA begin and when did you become permanently disabled? This information is critical to determining if you are even eligible for the 11 month extension - it's not automatic.
 

I_cant_fnd_help

Junior Member
I quit my job in Feb 04 because they cut the sales commissions from 25% to 3%.
I'm 56 and have been doing this since 1974 at 3) Companies.

Disability:
1st surgery by an incompetent podiatrist: Nov. 2000

2nd surgery by same (dubious) doctor to correct extreme pain that caused me to pass out on a customers shop floor: October 2001

3rd surgery by a well known orthopaedic surgeon who was supposed to have fixed these Stump Neuromas & the accompanying daily pain after many rehabilititon efforts failed, drugs tried, prothetics failed, etc: August 2003.

So when I did I become disabled: my best guess is: I discovered it was going to be permanent about December 2003.

I was issued a permanently disabled licence placard by the 1st doctor on about July 2002.

Unfortunately, the Statute of Limitations on mangling a patient is 2) years here or I would have taken that dang kid podiatrist to court.

God Bless for the reply!

Steve
 

Mrs3

Junior Member
Just looking around the web I found some information from companies in Kansas and their Cobra policy. This does not mean it pertains to your policy as I do not know where you work - but in general I think the Cobra policies depend on the state they are operating from. You may also want to check out the Kansas State Insurance website.
http://www.ksinsurance.org/

It is my understanding you must be considered disabled and receiving LTD or SSDI to qualify. I do not know if that pertains to Kansas - but judging by some of the information below, I believe so.

Hope some of it helps.

Disability extension of 18-month period of continuation coverage

If you or anyone in your family covered under the Plan is determined by the Social Security Administration to be disabled at any time during the first 60 days of COBRA continuation coverage and you notify the Plan Administrator in a timely fashion, you and your entire family can receive up to an additional 11 months of COBRA continuation coverage, for a total maximum of 29 months. You must make sure that the Plan Administrator is notified of the Social Security Administration’s determination within 60 days of the date of the determination and before the end of the 18-month period of COBRA continuation coverage. This notice along with all appropriate information or documentation should be sent to: Rae York, Benefits Coordinator, Office of Human Resources, GEB 251, Box 46, 12345 College Blvd., Overland Park, KS, 66210.
This is just something I found regarding Kansas Insurance Law and may give you a direction to search.

SECTION 3 — EXTENSION OF STATE CONTINUATION OF BENEFITS
A study would be undertaken by the Kansas Insurance Department to assess the impact of extending state continuation of benefits from 6 months to 18 months. The bill mentions “extending continuation of benefits under COBRA” but this extension refers more accurately to the Kansas Continuation Law, which is part of K.S.A. 40-2209. The Kansas Continuation Laws pertain to individuals who do not qualify under COBRA benefits continuation and was established as a part of state insurance statute prior to the existence of COBRA.
 

cbg

I'm a Northern Girl
COBRA is a Federal law - it is NOT state specific. Many states also have health continuation laws but COBRA is Federal. That doesn't mean there can't be a KS local office but COBRA is the same everywhere in the US.

If, as his second post seems to indicate, the OP has already been on COBRA since February of 04, there are no further extensions available. COBRA in most cases is available for 18 months, with a potential 11 month extension to 29 months. The maximum the law requires, with very rare exceptions that apply ONLY when there is a second qualifying event (which does not appear to be the case here) is 36 months.

February 04 through July 07 is more than 36 months. There are no further extensions available.

Any continuation available through Kansas state law ran out in August of 04.
 

I_cant_fnd_help

Junior Member
They (meaning my ex employer) is going to fight this I guess, in a professional and courteous manner:

The reply I got yesterday was:
Where a loss of coverage is a result of an Employee's termination of
employment (other than by reason of Gross Misconduct) ->NOT APPLICABLE<- or reduction in
hours ->NOT APPLICABLE<- and a Qualified Beneficiary ->NOT APPLICABLE<- is determined by the Social Security
Administration to be disabled (for Social Security disability purposes)
before, at, or within 60 days of the date of the Qualifying Event, all
Qualified Beneficiaries within that family are entitled to COBRA for a
maximum period of 29 months. To benefit from this extension, any
Qualified Beneficiary within the family ->NOT APPLICABLE<- must notify the Plan
Administrator as required by the reasonable procedures established by
the Plan Administrator.

Where a Qualified Beneficiary was determined disabled by the Social
Security Administration prior to the Qualifying Event, the Qualified
Beneficiary is considered to meet the statutory requirement of being
disabled "within the first 60 days of COBRA coverage."
Matter of fact:
I was (I guess??) Permanently disabled within the first 60 days of COBRA coverage which started in Feb 04: they knew that, but I didn't officially contact them.
Pure ignorance (lack of knowledge vs Studity): which is permanent too. :)

So: I am in a state of desperation.

I can't find a job, I'm too old, too disabled, yet: too young and don't qualify for Social Security benefits.

Looks like I am screwed, unless anyone has has a reference on how to get enrolled in the Kansas Disaster Insurance type Med Insurance policy so they can't take all my life savings in the event of a very costly medical occurance (or) get an attorney get involved.

I am kind of a mental mess today over this.
Anxiety attack city! :confused:

Steve
 

cbg

I'm a Northern Girl
If you have been on COBRA since February of 2004, you've already had your 11 month extension and more. As I said above, except in rare circumstances which do not apply here, when you quit your job you get 18 months of COBRA. An 11 month extension in the circumstances you describe is possible, bringing it to 29 months. The maximum an employer is EVER required to provide is 36 months, again barring rare exceptions that do not appear to apply here. You've been on COBRA for 41 months. Your employer has no legal obligation to extend it any further.
 

Betty

Senior Member
Agree, you are already over the max. required amt. of time for COBRA & your ex-employer does not have to continue it any longer.

You noted you are too young for soc. sec. benefits. Maybe you might qualify for soc. sec. disability benefits if you are determined disabled by their standards.
 

I_cant_fnd_help

Junior Member
My mistake, terribly sorry - It started in 06 and NOT 04.

I am TERRIBLY sorry :eek: for the mis-information.

Please excuse me.

I was and still am a nervous wreck over this.

My Cobra started in February of 06, and NOT 04. :confused:

Therefore: it will be 18 months on 8/31/07.

May we begin anew please?

I plan on calling an attorney referred by the NOSSCR line today at: 1-800-431-2804.
I'll post the results for benefit of others in similar situations.
 

I_cant_fnd_help

Junior Member
The Second:"Qualifying Event"

Kansas

Here is what I'm (kind of) banking on from:

http://www.pueblo.gsa.gov/cic_text/employ/cobra/cobra.htm#duration

If you are entitled to an 18-month maximum period of continuation coverage, you may become eligible for an extension of the maximum time period in two circumstances. The first is when a qualified beneficiary (either you or a family member) is disabled; the second is when a second qualifying event occurs.
Disability
If any one of the qualified beneficiaries in your family is disabled and meets certain requirements, all of the qualified beneficiaries receiving continuation coverage due to a single qualifying event are entitled to an 11-month extension of the maximum period of continuation coverage (for a total maximum period of 29 months of continuation coverage). The plan can charge qualified beneficiaries an increased premium, up to 150 percent of the cost of coverage, during the 11-month disability extension.
The requirements are, first, that the disabled qualified beneficiary must be determined by the Social Security Administration (SSA) to be disabled at some point during the first 60 days of continuation coverage, and, second, that the disability must continue during the rest of the 18- month period of continuation coverage.
The disabled qualified beneficiary or another person on his or her behalf must also notify the plan of the SSA determination. The plan can set a time limit for providing this notice of disability, but the time limit cannot be shorter than 60 days, starting from the latest of: (1) the date on which SSA issues the disability determination; (2) the date on which the qualifying event occurs; or (3) the date on which the qualified beneficiary receives the COBRA general notice.
The right to the disability extension may be terminated if the SSA determines that the disabled qualified beneficiary is no longer disabled. The plan can require qualified beneficiaries receiving the disability extension to notify it if the SSA makes such a determination, although the plan must give the qualified beneficiaries at least 30 days after the SSA determination to do so.
The rules for how to give a disability notice and a notice of no longer being disabled should be described in the plan’s SPD (and in the election notice if you are offered an 18-month maximum period of continuation coverage).


I wanna shoot myself in the foot (the functional one) for procrastinatiing on this, but every single doctor I consulted with claimed it would get better.

Right!
Along with an addiction to pain meds I neither need nor want. :mad:
 

I_cant_fnd_help

Junior Member
Scra-rued in Kansas.

Here is the way this worked out for the benefit of someone else battling disability, the state of Medicine in the USA, and how this worked for me.

The State of Kansas has one of the largest backlogs of SS disability cases in the nation: 11,704 to be fairly close.

An attorney told me:
You will never make it through the 1st cut on disability benefits, because you could be a Walmart Greeter."
"After that, it would take so long to get SS benefits, you'd either be dead, or legally eligible by that time."
Frapping Great: a 5 year degree in Electrical Engineering and an MBA: ends up a Walmart Greeter. :rolleyes:

Regarding the extension of my Cobra:
That lazy arrogant nurse neglected to
get to it
: so I was late filing within the 60 day notification period.
Wonderful. :mad:

I signed up today in the Kansas High Risk pool (permanent disability in my right foot caused by an imcompetent podiatrist): $560 per month (with a few supplementary policies: like cancer) and I can't get a job that will allow me to:
A) Be on narcotic pain meds at work.
B) Soak my foot in a bucket of ice water every 4-6 hours.
C) Crawl around the office on bad pain days.

I have to spend $10,000 before I even qualify for their cr*p (and dubious) benefits.

So: I am terminally F-ed for 3.5 years and headed for bankruptcy, or making pencils and brooms. :cool:

I wish I had the courage to put a bullet in my head. And I'm NOT joking around.

Scra-rued in Kansas. :mad: :mad:
 

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