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What is my course of action against my plan administrator/former employer for failing to get me a COBRA election notice on time?

Los Angeles, CA |

My contract was ended on the 2nd to last week of May 2012 at the temp agency I worked for. I did not receive a COBRA election form until September 10. The temp agency claims that I was not considered "terminated" at the moment I was released, but no payments were made to my health insurance plan during the period between when I was released and my "termination," which they put at at the end of July. I spoke to them, and, while admitting no wrong doing, they offered to pay the full premiums for this 6 week period.

However, I am having a problem with the plan administrator. In spite of repeated phone calls, they did not get me the COBRA form until the first week of September. The header on the COBRA notice says August 14, 2012, but the meter on the envelope says September 7 (I have of course retained this). I tried to email them with the evidence, and ask them to waive the retroactive premiums, but they refused to respond. Therefore, I filed a complaint with the DOL, and I now received a phone call from the plan administrator. They claim that they sent the election form on time, but somehow it didn't get to me, so they re-sent it. I refused to budge, and said that I would have to think about how to handle this. I don't know if they are lying to cover up a system glitch or what, but the fact remains that I did not get ANYTHING from them until September 10th.

The problem I am having is that the retroactive premium is quite expensive (about $250), and that I was completely in the dark while I was waiting for the form. I did not know that I needed to save receipts for prescriptions etc, and now I am not sure if I can get the receipts back so I can be reimbursed.

I am not sure what to do now. I have not been contacted by the DOL yet.

What do I do now?

I should also add that they said that I am running out of time to send the notice in, the deadline being Oct 13, but that they are willing to give me a "grace" period and still let me send it.

Attorney Answers 2


It sounds like you are doing the right things in pursuing your COBRA rights. There are penalties for failure to provide the notice but the plan appears to be taking care of the situation, at least for the most part, and at least so far. Keep the pressure up and you are likely to get the plan to cover the retroactive payment, too, as $250 is a drop in the hat to an insurance company, despite that it is a lot of money for ordinary people who are out of work.

Most and perhaps all pharmacies will provide their customers with a print out of all their prescriptions and the cost. Most have this information in their computer system and all you have to do is call to confirm the availability, then go pick it up. Doctors' offices and medical facilities maintain similar records.

*** All legal actions have time limits, called statutes of limitation. If you miss the deadline for filing your claim, you will lose the opportunity to pursue your case. Please consult with an experienced employment attorney as soon as possible to better preserve your rights. *** Marilynn Mika Spencer provides information on Avvo as a service to the public, primarily when general information may be of assistance. Avvo is not an appropriate forum for an in-depth response or a detailed analysis. These comments are for information only and should not be considered legal advice. Legal advice must pertain to specific, detailed facts. No attorney-client relationship is created based on this information exchange. *** Marilynn Mika Spencer is licensed to practice law before all state and federal courts in California, and can appear before administrative agencies throughout the country. She is eligible to represent clients in other states on a pro hac vice basis. ***

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Please see the following website that outlines several ways to register complaints about the handling of COBRA matters. It should give you some guidance that you need. Good luck to you.

This answer should not be construed to create any attorney-client relationship. Such a relationship can be formed only through the mutual execution of an attorney-client agreement. The answer given is based on the extremely limited facts provided and the proper course of action might change significantly with the introduction of other facts. All who read this answer should not rely on the answer to govern their conduct. Please seek the advice of competent counsel after disclosing all facts to that attorney. This answer is intended for California residents only. The answering party is only licensed to practice in the State of California.

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