Cobra misunderstanding !

[Guest Mike Cardone]

My wife is a nurse and was injuried at work. We have been paying our health insurance to the hospital since June of 2000. As of April 2001 my wife received a certified letter terminating her employment with the hospital. We then received the forms for Cobra. On the form is a termination date. We contacted the hospital and they informed us that they would input the date. They said our Cobra payments started in June 2000 and will be ending November of 2001. My understanding is that Cobra starts after termination, not unable to work under Doctors orders. We have never signed anything from the hospital pertaining to Cobra. Do we have grounds to fight this?

[Mary C]

COBRA can start at termination of employment or a reduction in hours. Being off work due to doctors orders or a disability leave can be considered a reduction in hours. The employer can choose to allow someone to continue to pay the active employee rate during part of their of the COBRA period or the full 102% allowed by the regulations, as long as the do so in a consistent manner. The medical summary plan description may give more insight into how they handle terminatnion of coverage while on disability, etc.

[KIP KRAUS]

In my opinion the employer should have informed your wife that she was on COBRA during her disability in some manner. Perhaps it’s is explained that way in the SPD, but I would be surprised if it was. If there was nothing in writing stating that your wife was on COBRA during her disability period I would question the COBRA start date.

Was she paying the COBRA premiums or the regular employee contribution that active employees pay? If she was paying active employee rates I’d be suspect that she was on COBRA in June 2000. It’s not uncommon for an employer to allow an employee to continue medical coverage for a period of time during a disability and then offer COBRA.

I’d call them on it and then if you don’t get a positive response you may want to contact an attorney or the DOL.