COBRA - Timely Notice

Kristie

What are a company's obligations when an employee fails to report a divorce and continues to carry an ex-spouse on health insurance. The divorce was 2 years ago. Specifically, must we, can we, refund premiums? Paid claims will now be reprocessed for payment by the individual. Do we now offer COBRA to the ex-spouse? Does this mean the ex-spouse was uncovered during the last 2 years and so there is no HIPAA advantage?

NaeNae55

I had a similar situation to this about 7 or 8 years ago. Your insurance carrier probably has a policy on this. I suggest you contact them.

Do you know if the ex-spouse has had other coverage during this period? It seems strange that no one notified you for so long. I would call your carrier immediately to get an end of coverage date (they might not want to go back the full 2 years) and send a COBRA notice ASAP. The COBRA coverage will start upon termination of the coverage as the carrier designates. The ex-spouse will then have quite a few months of coverage to make up. However, as long as you send your notice out ASAP, you should be ok (timely notice starts upon your finding out that a notice needs to be sent, not upon when it should have been). Also, unless the ex-spouse had lots of claims, he probably will not apply for COBRA.

If the carrier goes back 18 months or more, the ex-spouse choose not to elect COBRA, and he has no other insurance, you are right...HIPAA will not apply.

Good luck!