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Cobra Cancellation

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Bilbojr

New member
Here are the facts of my case.
1. I live in Florida but the company I worked for is in Rhode Island and I was living in Mass at the time, I moved to Florida for a new job.
2. I am 58 years old and my wife is 55. My disabled son is 30 and is on the plan too.
3. We are high users of medical insurance.
4. I worked for the company from November 2016 until August 2017 and was terminated without warning or cause in August 2017. The company relocated me to Mass from Las Vegas and paid a head hunter less than a year before.
5. The company covered my medical under their regular plan until Oct 1 2017.
6. I paid regularly from 10/1/2017 thru 8/1/2018 and then had a problem paying starting in Sept 2018. I fell behind one month in September 2018
My Sept 2018 payment was 32 days late, My October payment was 39 days late, my November payment was 30 days late.
7. In December I thought I had setup automatic payments starting in December but they did not occur and I did not notice this until I was denied coverage on Jan 6, 2019
8. I made a full payment on 1/7 to pay for Dec and Jan which would mean my Dec payment would have been 37 days late and my Jan payment would have been 6 days late but basically within the grace period.
9. I contacted the insurance company for reinstatement by phone on 1/7/19 and they said I needed to send an email requesting reinstatement which I did. It was denied on 1/8 but I never got an email (it went to spam) until i called on 1/9 and they said they sent it.
10. I then asked for reconsideration on 1/10 as my payment of 1/7 was processed and applied to account but sitting as a credit. This email they said they never received so I sent again on 1/11 with them on the phone and they said they received it
11. I found out on 1/14 when I called that reinstatement was up to my old employer
12. I called them and talked with HR assistant who told me they did not have all the information from the insurance company
13. So I sent an email to HR which was a copy of what I sent to the insurance company and which showed the first denial from the insurance company
14. My reasons for requesting reinstatement were lack of notification as the address on my account was never updated and I had not received any of the emails they listed on the account because I had moved out of state for a new job. With my payment history, they had never enforced this 30-day rule before and I had attempted to setup and make current my payment in December but it must not have happened and lastly, I made payment on 1/7/19 and it was processed and brought my account current
15 I got an acknowledgment email from HR and was told they would call me the next day
16. I tried to call them the next day as I did not hear back from them and I sent a follow-up email
17. I got an acknowledgment email back from HR but was told it was in the hands of the insurance company
18. I called insurance company on 1/18 and was told that the 2nd reinstatement request was denied by my former company and was not given any reason why and I was never notified about this in writing or by email. They said they were returning my funds and that this process started the day before.

The key points in my opinion are:
1. I was never notified of any issues on payments due to mail address change not happening and I had requested from HR that they change this in 1/2018 when I moved and again by phone in October 2018. I think this is why the automatic payment would not occur because the credit card I wanted to use address had changed but I don't know this for sure. I called the insurance company and the only one that could change my address was my former employer
2. I believe that this was really due to the high usage of insurance me and my family have and this company has a history of hiring and firing older workers before getting benefits.
3. There were times in the past where I was later with payment than I was when they terminated me and they did not attempt to cancel me so they don't enforce this rule consistently.

I know that Cobra rules say 30 day grace period and it is my fault for opening this door for them to do this, but at this point do I have any recourse? They made the cancellation retroactive to Dec 1 and in Decemeber, I and the family used insurance a lot without any thought it might be canceled. My son had a kidney transplant and some of the meds were are very expensive if paid out of pocket.

Any thoughts and opinion would be helpful. I am not a lawyer.
 


Bilbojr

New member
One additional note: I found this info on Cobra web site....

"Plans can terminate continuation coverage if full payment is not received before the end of a grace period. If the amount of a payment made to the plan is incorrect, but is not significantly less than the amount due, the plan must notify the qualified beneficiary of the deficiency and grant a reasonable period (for this purpose, 30 days is considered reasonable) to pay the difference. The plan is not obligated to send monthly premium notices, but must provide a notice of early termination if it terminates continuation coverage early due to failure to make a timely payment."

I never got the notice because my address on my account was wrong and on 1/17/2019 I got a notification from their system that my address had changed and I confirmed this on their website
 

FlyingRon

Senior Member
They legally CAN do what they did. They could look the other way, but in practice, I've found there's very little incentive for them to do so. You step over the line by one day and they'll pull it out from under you.

The only thing that bears looking into (and it would behoove you to contact an attorney) is whether them accepting payment should indeed indicate their willingness to at least cover you for the periods that the premium was funding.
 

cbg

I'm a Northern Girl
They not only are firmly on legal ground, they gave you more chances than they had to. As long as you were more than 30 days late ONCE, they have no legal obligation to allow reinstatement. You were 30 days late multiple times. Terming your coverage is legal. I understand your situation and I'm sorry. But I think the best you can hope for is coverage till the end of December, and with your history I'm not sure you can consider that a sure thing.
 
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