COBRA questions.....please help!

[Guest KellyB]

Let me explain my situation 1st.

Both myself and my husband I have had continuous insurance coverage with my employer for the last 10 years. This year in Jan, 2001 my husband began a new job. At open enrollment we chose to also put both of us on his plan too, and this was because his plan had coverage (infertility) for something we needed as what not covered through my employer.

In June of this year my husband had to quit his job due to a health problem. We were told we were eligible for COBRA insurance and so we decided to continue coverage through COBRA with his plan so we could continue our infertility treatment.

My questions are:

1. Is this legal to continue COBRA coverage if we are also continuing our coverage with my employer too? Is this dual coverage allowable.

2. If it is allowable, which plan is primary and which is secondary? If Cobra is secondary, must I 1st submit infertilty claims to the primary even though my primary is an HMO paln and am going out of state for treatment, and also that I know the primary wil pay nothing at all for infertilty anyway?

Thanks for your responses in advance.

Kelly

[Mary C]

Kelli

To answer your first question - as long as you already had coverage with your employer BEFORE you elect COBRA from your husband's employer, its OK. Its only when you obtain other group coverage AFTER you elect COBRA that your COBRA coverage will terminate. As for dual coverage - it used to happen all the time under the old fashioned traditional type coverage. However, some HMO's do not allow dual coverage, particularly if both employer plans are with the same HMO. You should check with your HMO to be sure.

To answer your second question - you should check each plan's summary plan description to determine which is primary and which is secondary. Generally, the plan from your employment is primary for you and your spouse's plan secondary. Same for your husband, the plan from his employment is usually primary and your plan would be secondary, but you'll need to check the SPD to be sure.

[Guest KellyB]

Mary,

Thanks for the reply, however I need a little more clarification please.

The HMO plan is BCBS, and it is with my work, and the Cobra plan that took effect here recently through husband's work was an Aetna PPO plan. Are you saying that even though the law states that is is legal to have dual coverage with our case scenarion, that even so, our HMO plan could still deny us coverage if they had a rule themselves stating coverage with another plan is not allowable?

Thanks,

Kelly