Cobra insurance will i qualify?

[melody007]

What is the name of your state?NJ

I started to work for this company in 9/2005-full time. They have approximately, 50+, employees, as far as i could count in our new year's party.
I also have health issuses that I know need medical insurance. I have had basic coverage for 2 years consistently for that purposes only.
Now, I have had this insurance(HMO) for 19 days now, and still my other insurance is active- if i pay the bill for 1/1/06. if i do not pay the bill it automatically stops on dec 31, 2005 and on 1/1/06, would be my only coverage-from my employer.
As per the company handbook, there is also mention of the cobra benifit-general description.
I have had medical and dental insurance since 1/1/06. I already have placed an order for my most expensive med which the local pharmacy covered and i bought it. So i tested it. and it is active.

Apperently, there is a personal situation has come up that I must attend to. It could be 2 months or 6+ months... I just don't know.

I must either stop working completely or work part time, if OK by employer,

Now i will let them know by 1-21-06 that i must reduce my hours to below 18 hours per week or if they wish stop to work completely.


so here are my questions:

Since i don't know, they will offer me cobra insurance, which i am willing to pay because of my health issues. I am in dought because i don't know the NJ or Federal law- that what is the minimum number of days or months you should be working and be covered under the employers insurance to qualify for cobra to becaome active if the employee voluntary reduce working hours or quits for personal reasons.

1- Will i get the option to select cobra insurance?

2- Should I pay for the health insurance that I carry on my own and when the cobra becomes active, i just drop my personal policy, and contiune with the cobra. or claim that my comapny policy became active as of 1/1/06, which iwas unaware of(Gray area) and they must refund the money since we are not allowed to carry two insurance in state of nj.

OR if i don't pay for my health insurace-personal policy, i will have to buy the personal policy within 30 days to prevent any preexsiting condition, if i am not offered cobra through my employer. now do the policies in nj become effective-lets says my employer policy last till 2/3/06 so i want to be effective by 3/1/06 to prevent preexesiting condition clause. Do NJ insurance companies make it active for new policy holders as of the next month or have to wait for the open enrollment period- nov 06, or jan of year 2007?

 

[mlane58]

Will i get the option to select cobra insurance?

As long as you qualify:
The statute specifies six triggering events that, if they result in a loss of coverage, can be qualifying events:

Death of the covered employee;
Voluntary or involuntary termination of the covered employee's employment other than by reason of gross misconduct (note that a retirement is considered a termination of employment);
Reduction in hours of the covered employee's employment;
Divorce or legal separation of the covered employee from the employee's spouse;
Dependent child ceasing to be a dependent child under the generally applicable requirements of the plan; and
An employer's bankruptcy, but only with respect to health coverage for retirees and their families.

Your plan administrator must notify "any qualified beneficiary" with respect to a qualifying event of his or her COBRA election rights within 14 days after it has been notified (by the employer or by a qualified beneficiary) that the qualifying event has occurred. If the plan administrator has not received notice that a qualifying event has occurred, they are not obligated to provide notice of COBRA election rights to the qualified beneficiary.

Then you as the qualified beneficiary may elect COBRA coverage at any time within 60 days after the date plan coverage terminates, or, if later 60 days after the date of the notice to the qualified beneficiary from the plan administrator. The 60-day period permits a qualified beneficiary to "adopt a wait-and-see approach to continued coverage, and then elect if and when medical care is required during the election period. If the plan administrator has not sent the notice of qualifying event, the election period remains open. The 60 day period is a minimum.

 

[melody007]

Will i qualify for the cobra benifit?

NJ is my state.

"Reduction in hours of the covered employee's employment; "

Does it matter if I reduce the numbers of hours, I want to work, or the employer tells me to work less hours, eithier way, does the above clause still apply to my situation?


Or since, I can not be there on full time basis for say 2-3 months , but I can return to work in say 2-3 months-the employer tells me not to come to work at all untill I am fully prepared to resume full time employment? does the above clause still apply to my situation?[/B]


With the above situation in mind will they still give me an option for cobra election in 14 days- if done by outside administrator, or if the company carries out its own duties of cobra formalities, they an take up to 45 days.



Thank you so much-in advance, for replying to this post.

 

[mlane58]

COBRA is a federal law, and the last time I checked NJ was still in the US and subject to federal laws, so yes it applies to you

 

[melody007]

will i qualify for Cobra insurance?

Thanks. so i do not have to keep my basic policy in-force and company policy at the same time. I will not be subject to preexsisting condition. If for one reason or the other if the company makes an error not issuing me a cobra, yjey will have a leagl problems in hand and DOL problems...

 

[melody007]

Cobra insurance will I qualify?

state NJ

From what I have read so far, I should not have any problems getting cobra coverage election and then invoking my health insurance throgh cobra.
Just for the sake of more clarity... I have 2 more questions:

1. Does the Federal or state law or any statue imply or directly say the number of days, weeks, or months employee has to work (I have been there since 4 months and have company sponsered heatlh plan from the employer) before cobra selection is made available to the employee? I will be requesting part time work as of feb 15, 2006 and will go and talk to them tomorrow.

2. Do I need to talk to my benifit admin in my office to remind her, sign any form(s), or give a letter to my employer-my immediate boss, or to the benifit office, that i am going to work part time starting Feb 15, 2006 and anticipate comback is in 8 weeks and ask will i get cobra selection.- My real qeuestion is, do I need to do any paper work, paper trail, so I don't get denied insurance through Cobra for any reason?

 

[melody007]

STATE NJ
" If the plan administrator has not recieved notice that a qualifying event has occurred " (they will not send me cobra election forms) from the very first reply.

How do i make sure that the administrator will recieve proper notification and there is NO problem in my getting this cobra coverage?

 

[cbg]

1. Neither Federal nor state law requires that you have been on the plan for any specified length of time. As long as you were on the plan AT ALL you will qualify for COBRA coverage. If your first day of coverage was March 1 and you were fired March 2, you would qualify for COBRA (as long as you were not fired for gross misconduct).

2. They have up to 45 days to notify you of your right to COBRA. You do not have to do anything to remind them. However, since you are clearly obsessing over this, nothing in the law says you can't call them and politely ask when you will be receiving your COBRA forms.

3. See above.

 

[melody007]

Sorry!!! if I have affended you by repeating or obsessing over my concerns, that is because I have a disease that requires very expensive meds. Therefore, I must pay attention to details, and yes I did call the attornies in my area(3 of them) and none were able to give a straight anwswer. So thank you again for all the responses. I will be member who will always recomend this site and read as many post here as possible.

 

[cbg]

I'm not offended. It's clear that this is very important to you. But you are asking questions that we do not have any control over the answer to. There's no way I can give you a guaranteed way to make sure that you get the papers sent in time because I have no knowledge of your former employer's procedures, or even whether they self-administer COBRA or use a third party.

The law does not require that you ask for the information. But it's obvious you will feel much better once this is settled. So the best thing you can do is call and ask when you will receive your COBRA info.

A piece of advice; when you send the completed forms back, send your first payment at the same time. It's not required, but most companies will not reinstate your insurance until they've received the check. So the sooner you make your first payment, the sooner the whole process will be complete.