I believe former employer is overcharging me for COBRA coverage.

[Guest mpp39]

My employment ended on Dec 31,2000. I informed my former employer to set me up with COBRA coverage for my wife and me. At that time the Health Plan was a PPO with Empire BLue Cross. I was advised that the premium would be $548.00 monthly . At that time the companies policy was that the employee paid 30% of single coverage and would absorb any additional cost for family coverage. The employer picked up 70% of Single coverage.I made 4 payment of $548 to date.

The company went into a partial self insured program March 1,2001 and i have now been advised that family coverage will now run over $1000 per month for essentially the same coverage. Contributions by employees are about the same as before, $240 a month for family.

I know this company well and there is no way they are going to increase their contribution to the tune of $7000 a year for each employee covered for family. They went into self-insured to save money. I am told that actuarials were used to come up with the premiums. I believe that something is wrong here. I would appreciate input from anyone that has a comment.By the way this is a company with about 500 employees,of which 150 employees in about 15 different states are enrolled in the health insurance plan.Thanks

[Guest jsga]

Regulations stipulate that a self-funded plan may use actuarial determined rates for COBRA.

[david rigby]

$1000 per month!!!!!!!!!!!

Seems very likey that other coverage would be available much less than this.

[KIP KRAUS]

Most employers who go from a fully insured medical plan to a self-insured or partially self-insured plan do so to save money. I find it hard to believe that their fully insured equivalent rate for COBRA would go from $548 to $1,000. If it did they’re getting shafted by someone. I can’t see how an actuarial calculation got increase that much.

By the way, a fully insured rate of $548 for the Empire Blues plan is reasonable. In upstate NY our HMO COBRA rates with BCBS in Rochester are $573.

[Guest AHayhow]

Are employers required to share with COBRA enrollees and/or notifieds how the premiums for the self-insured plans are calculated? I have an employer group who just completed the annual actuarial review for their self-funded plan. As a result, the monthly COBRA premium increased.

One of the participants insisted she talked with the DOL and was told she can request the documentation used by the actuary in determining the new rates. I have searched the regulations and the message board and can't find anything that substantiates (or denies) this.

[Kirk Maldonado]

I know of plans where the unsubsidized rate for a family is $1,000 per month, even plans with relatively high deductibles. Remember that insurance premiums have skyrocketed in the past few years.