Recent COBRA rulings

[Guest ABRAHAM]

I heard that a recent court decision has ruled that the 60 day COBRA election period begins on the date the qualified beneficiary receives the notice. Does anyone know if this is true?

Also, I heard that all health plan beneficiaries must be notified of their COBRA rights individually. Does this mean that we need to send a COBRA package to everyone in the family that had coverage at the time of the qualifying event?

Thanks for your help!

[Guest Lori Senter]

At an AE Roberts COBRA seminar, they said that it is better to count the 60 days from the time the employee receives the notice. They said that in the unlikely event it ever went to court if you denied their coverage, and they showed it was a few days more than 60 days (because of mail, usually), then the court would look more favorably on them.

As for notifying every participant, the way this has always been handled where I've worked was to do a notice for the employee showing all dependents who had coverage. If the employee declines coverage for the family, the spouse must sign consent. We also did one notice that covered all dependents for HIPAA.

Hope this helps.

[Guest Penn]

We have been advised to mail both the initial notice and the QE notice to both the ee and covered spouse. I don't like your idea of having the spouse sign off when the ee has declined on behalf of the family - what do you do when they "decline" by not replying? You need to prove that you notified the spouse of his/her rights.

[Guest Mary Ridgeway]

Employee terminated 10/3. Employer carried ins. thru 12/1 (according to ins. co.). Employee paid 1st premium with written notice stating what it was for and asked that the employer call and notify the ins. co. of desire to be enrolled in Cobra. Have copy of letter. Never enrolled in Cobra. No coverage now in effect? Can you help?

[KIP KRAUS]

With regard to the 60-day period, I believe the regs state that the 60 days starts either on the date of the QE or the date of the notice. I agree that it makes sense to allow mailing time before you start the 60-day period. Employers who worry about a day or two, in opinion are being unreasonable and it could get them in more trouble than it is worth.

Lori, the thing about having the employee refuse coverage for the entire family and then having the family consent seems to be a waist of paper to me. I go along with Penn that if they don’t reply what really can you do? In addition, it is my understanding that even if they initially refuse coverage and they decide to elect coverage later (within the 60-day period) they can do so, and their written refusal has no effect.

[Mary C]

Mary -

I've read your posting on various threads on this board. You can check the DOL website for COBRA information.

One explanation of why you show canceled 12/1 - based on the timing you gave above and elsewhere, if you terminated on 10/3, and the company's normal practice was to continue coverage to the end of the month, your COBRA period started 11/1, regardless of when you were notified or paid the first premium. You stated you sent one check. Generally under the regs, that money must be applied to purchase coverage beginning with the day after the last day you had active group coverage, or November 1. That could be why the insurance company shows you as canceled 12/1.

Many people think COBRA starts when they sign the election form and return a check and that the check buys coverage going forward only. However, unless you first declined coverage then revoked that waiver within 60 days of the date you were notified, COBRA coverage begin reto to the day you lost group coverage. So if only one month's premium was paid with your election, you could have been two or three months behind in payments from the start.

Good luck.