by Tussanee » Sun Oct 11, 2009 01:04 am
My spouse was laid of on January 14, 2009. Cobra effective date was February 1, 2009. I was paying 1470.00 per month, through May 2009. Took stimulus package my portion was 35% which was credited to cover the Cobra payment until August. I spoke with Insurance admin wants to know when I should start paying my portion of 35% they told me not until September 09, c/s also told me that since my sept. payment was small amount I could combined it with October payment which I did. My son has hd 2 pnuemo thorax was hospitalized several times since. Now they say I am no longer coverage. Is this legal.
Posted: Sun Oct 11, 2009 03:23 am Post Subject:
COBRA only ends when:
** The premium isn't paid on a timely basis. The first premium payment must be made within 45 days after the date COBRA elected. the premium payment required is typically retroactive to the end of the plan's employee coverage. Your next premium payments are due on the date shown in the plan with a minimum 30-day grace period for payments. Your premium is considered paid on the date you mailed it (postmark date).
** The coverage period ends. This is normally 18 months, but can be extended to 29 months if the beneficiary is considered "Social Security Disabled" within the first 60 days after COBRA started and for 36 months for divorces, deaths, kids, etc.
** The group plan itself went "blooey" because, for example, your former employer went out of business or failed to pay the premium.
Back to your :?: Even though most COBRA premiums require monthly payments, it's legal to have them paid at other intervals. But even if payments are required, say quarterly, I have never heard of HR departments or other benefit departments tell someone they could "combine" the required monthly payments because the payment was "so small." 35% of your stated $1400 monthly premium is till a chunk of change at $490 a month. If you're still within your grace period, your coverage will be reinstated. If your son's claims occurred during the grace period, they might be covered by the plan. Most plans I've seen will hold the claims and then process them if payment is made during the grace period, although they can deny the coverage. I rarely have seen that.
Finally, if you haven't made the premium payment within the stated grace period, your coverage has lapsed and the claims probably won't be paid.
You need to make sure whomever you're talking to has actually viewed the plan documents, and you have a right to view those same documents at the former place of employment.
Hope this helps...let us know what's up.
InsTeacher 8)
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