NEED ADVICE ASAP

njjel · February 2003

Employee has been out on FMLA leave. Leave expires 2/14/03 however the leave of absence has been extended to 4/1/03 (even tho FMLA has expired). The employee is being asked however to pay for her medical insurance for a month and a half under COBRA. Can I advise her today that she needs to pay for the balance of February and then for the month of March? I don't think so.

sandra_d · February 2003

I believe that she needs to be offered COBRA as anyone else would (in writing), she would need to elect COBRA within the timeframe everyone else is permitted to (60 days) and payment would be due when it is for anyone else electing COBRA (it's been a while since I've administered COBRA - but I think it is within 45 days of choosing COBRA continuation). So, no, I don't think you can require immediate payment.

morrisg · February 2003

Once your employee runs her FMLA time you are no longer require to carry benefits, but a leave of absence, much like a lay off would activate her CORBRA benefits elgiblity and thus she would be elgible for COBRA.

njjel · February 2003

Yes, thanks I do understand that. My question though is I lack what I think is the required time to notify her AND have her pay for 1/2 of February.

morrisg · February 2003

Actually the employee is not required to make any COBRA payment until at least 45 days after the date that the employee wishes to take avantage of COBRA. However employees are required to notify employers of thier election to do so within 60 days AFTER being notified of thier COBRA rights. So an employee could go 60 days, notify the employer and then still have an addtional 45 days before payment is due, for a totla of 105 days.

njjel · February 2003

[font size="1" color="#FF0000"]LAST EDITED ON 02-13-03 AT 11:50AM (CST)[/font][p]Yes, that is correct. However, she would not have any insurance if she waits any time beyond tomorrow to elect COBRA and tht's where I believe the problem would come in if I do as my supervisor wishes.

sandra_d · February 2003

I'm confused ... why would she not have insurance beyond tomorrow?

I don't know about your state, but in MN our state law is that insurance cannot be canceled except and the end of the month. If in your state, and by your insurance group contract, you are allowed to cancel her insurance mid-month, then cancel it and extend a COBRA offer. She will have 60ish days to respond "yes" plus another 45ish days to pay. Once she elects COBRA, then you reinstate her coverage back to the time it was terminated, so that there is no break in coverage. If she doesn't elect or pay COBRA, then her insurance is never reinstated...unless she does come back to work 4/1/03, in which case you should check your insurance contract to determine eligibility (whether she is immediately reinstated, or if she must go through a waiting period again, as if a new employee, etc.)

Your supervisor cannot go around the law...

Sorry if I'm totally not getting what your question is!

njjel · February 2003

Right she has 60 days to respond but she does NOT have insurance coverage until she elects COBRA. Thanks.

sandra_d · February 2003

True - no insurance until she elects COBRA. But, when she elects, it is reinstated retroactively to when it was canceled, so assuming she elects, there is no break in coverage.

njjel · February 2003

Right. However, she is currently on leave due to illness and medicaly treatment is required weekly. therefore, she'd either have to pay out of pocket (not an option for her due to finances) or go without.

LindaS · February 2003

What I advise people in this situation is that once they use the insurance, they need to elect COBRA. It may take a couple of weeks for the paperwork to go through the computer system and there may be a possibility that the clinic will have to send the billing through a second time but there will be coverage when she needs it. If, in the end, she does not pay for her COBRA coverage then you go back and re-terminate her coverage for that time period and then its up to the insurance company and the clinics to deal with.
You cannot require advance payment due to the COBRA guidelines.

NEED ADVICE ASAP

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