- 7,089
Thanks for the response. that may help the agents give you advice more specific to your situation.
Wife kicked of my insurance. Can she get Cobra?
- Thread starter Cappy
- Start date
- Thread starter
- #12
Something does not add up here, so bear with me. And please be short and specific with your answers, this is not the most ideal method to help you.
Specifically, what did the dependent verification person tell you the reason was?
What date did your wife/dependents become covered under your insurance plan?
What date did she/they lose coverage?
What type of documents were you sending to them, please be specific?
Reason I ask these questions is it sounds as if your/dependents may; 1) not have ever been on the plan, or 2) perhaps the group was doing a dependent verification audit and could not verify eligibility and termed them.
The fact that you were trying to send them paperwork is curious. If a dependent was covered and consequently termed by accident, it is rare that you would need to provide paperwork. As said by others earlier, that situation usually needs a quick phone call or email from employer.
Thanks
Specifically, what did the dependent verification person tell you the reason was?
What date did your wife/dependents become covered under your insurance plan?
What date did she/they lose coverage?
What type of documents were you sending to them, please be specific?
Reason I ask these questions is it sounds as if your/dependents may; 1) not have ever been on the plan, or 2) perhaps the group was doing a dependent verification audit and could not verify eligibility and termed them.
The fact that you were trying to send them paperwork is curious. If a dependent was covered and consequently termed by accident, it is rare that you would need to provide paperwork. As said by others earlier, that situation usually needs a quick phone call or email from employer.
Thanks
ACA is not retroactive. You may get a 5/1 effective date and out of pocket expenses start over. Even so, that may be your best option depending on what the exact situation turns out to be especially whether your wife was originally enrolled timely.
You haven't said whether this is a fully insured or self funded plan. Details matter.
You haven't said whether this is a fully insured or self funded plan. Details matter.
The Benefit Coach
Expert
- 42
I've ran across a number of employers in the past couple of years that have adopted the policy of outright disallowing spouses for coverage if they (the spouse) have access to coverage through their own employer, as opposed to levying a surcharge. Most had a fairly robust verification process, so this may be where the disconnect happened.
If you previously submitted your employers required information, and they didn't process it, then this is just a clerical error that should be correctable. On the other hand, if you didn't submit the information to them by their cutoff date, then your position is much weaker.
If your spouse was dropped from your coverage because she was deemed "ineligible", then she would ineligible for COBRA as well.
If you previously submitted your employers required information, and they didn't process it, then this is just a clerical error that should be correctable. On the other hand, if you didn't submit the information to them by their cutoff date, then your position is much weaker.
If your spouse was dropped from your coverage because she was deemed "ineligible", then she would ineligible for COBRA as well.
IF...and there are several: 1) your company has over 20 EEs, 2) your wife was on the group health plan, and 3) the ER did not send your wife her own notice that she was losing coverage, THEN the probability is high the ER violated the COBRA notification rules, and thus you might have cause for legal action against the ER. If that be the case, it appears the ER invariably loses. According to some stats from InfiniSource from several years ago, out of 750 federal court cases involving COBRA, the ER lost 748. If they don't offer her COBRA, check with your attorney.
COBRA is a Federal right and your regional US Department of Labor representative can help you protect are your rights. Also your US Senators offices and local Federal Congressperson may have resources that help with unraveling your options. In Connecticut they are a vital bridge to our ACA marketplace.
Speed recovery to your wife!
Speed recovery to your wife!
- Thread starter
- #20
Sorry. I've been busy with a lot of things with my wife being in the ICU and everything.
So, our coverage started January 1st as this is a new job that started in November. They are saying they covered her until middle of March, at which point they cancelled the insurance without telling me. They are claiming they don't have any of the documents that we sent them proving eligibility. My wife had sent them our marriage certificate and a copy of our tax return. So I guess they are claiming my wife was never eligible and therefore won't be eligible for COBRA?
One thing, apparently the employer wasn't satisfied with what my wife had initially sent regarding one of my daughters, and had required us to resend it. My wife was supposed to have done that; if she didn't, would they cancel insurance for all my dependents? Not just the one dependent who's documents they didn't like? It seems weird to me that they received documents for everyone, questioned the daughter's documents (implying the rest are okay,) and then cancelled insurance for my wife claiming they don't have any documents for her. Are they allowed to deny coverage for all my dependents if they aren't satisfied regarding the eligibility of just one of them?
When we get the $500,000 hospital bill, maybe we just don't pay it? The hospital is owned by my employer, funnily enough.
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