COBRA Maternity Question

scantey

I have an ex-employee who was terminated in her seventh month of pregnancy by her own fault. She was however eligible for COBRA so her 8th month she paid into the HMO coverage she elected but in her 9th month they changed the plans and she was not given a choice but to go to the new plan a PPO. She had the baby but since she was now in a PPO she has to pay a $1500.00 deductible. Her argument is that we changed plans and she was happy with the HMO where she would not have had to pay a dime. Are we responsible for this at all? This happened before I came on board but I tend to think the employee should have been given a choice. Any takers?

Margaret Morford

Usually when there is a change in plans, the old plan gives you a grace period to cover on-going medical conditions of short duration. If there was no grace period negotiated, I think your ex-employee is stuck with the new plan. COBRA recipients have to go with the employers plan whether they want to or not. They always have the option not to pay for the new plan if they don't like it. While it's not in keeping with our HR sense of taking care of employees, most employers focus on doing what's the best thing for their current employees, even if it is to the detriment of their ex-employees.

Margaret Morford
theHRedge
615-371-8200
[email]mmorford@mleesmith.com[/email]
[url]http://www.thehredge.net[/url]