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Advice needed please.


Guest aprilszoo

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Guest aprilszoo

I hope someone can help answer a question for me...

My husband was laid-off in May, and we elected COBRA in order to avoid potential problems with Pre-existing condition issues should his unemployment end up lasting more than the magic 180 days.

Well, thankfully, he found a new job ... but the problem is that when the job offer was made, the company misrepresented the health plan benefits ... and it turns out they are useless to our family. We thought we could just continue on COBRA a while longer until they transfer us to a new state in 4 months or so, where there is a health plan available that meets our needs. But their HR dept says we can't do that and that once we become eligible for benefits (Nov 1) our COBRA will be terminated.

This doesn't seem right. Can't we keep the COBRA somehow?

Can anyone shed some light on this for me?

Thank you,

April and the Zoo

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April -

The answer is yes and no (remember nothing is ever clear cut when government regulations are involved). The regulations governing COBRA say that the COBRA coverage can end early if you become ENROLLED (not just eligible) in another employer group health care plan. Now if the coverage in the new plan is automatic as soon as you are eligible and you don't have to do anything to be enrolled (fill out a form, pay part of the cost, etc), then technically your COBRA coverage should end. There is, of course, an exception to this - if the new employer group health care plan has pre-existing condition limitation, you can continue your COBRA coverage in order to cover these pre-ex conditions until they would become covered under the new plan.

Then there's the enrollment criteria under the new plan to consider. Maybe the only time you can enroll is when your initially eligible, for example 11/1, and there are no provisions to allow you to enroll in it in four months. Would it then be worth giving up coverage till an open enrollment period just to keep your COBRA? This is something you should also check out.

Hope this helps.

Mary

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Sounds to me as if there shouldn’t be a pre-existing condition problem, because your husband seems to have credible coverage under HIPAA? Sounds to me like the new plan may not cover as much in terms of reimbursement for your husband’s condition. If that is the case I don’t think he can be enrolled in both plans.

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Guest taylorjeff

I have some suspicions, but rather than guess, let me ask you. You say the company misrepresented the benefits and they're useless to you. What are the benefits? Why are they useless? Is it a network issue (lack of doctors, hospitals)?

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