top of page
  • ron7732

Lost Health-Care Coverage

Shortly after he was fired from his job, Monty got married and left town for a three-week honeymoon. While he was away, his former employer sent him a notice about his right under a federal law, called COBRA for short, to elect to continue his health-care insurance coverage. COBRA requires that such a written notice be provided within 14 days of a termination from employment, but neither the statute nor regulations spell out what adequate notice entails.

In Monty’s case, he never got the notice, which was sent by certified mail, return receipt requested. When Monty went to the post office to claim the letter, postal workers could not find it. Eventually, the COBRA notice was found, but then it was returned to the sender with an erroneous indication that Monty never claimed it. By that time, Monty had begun a new job and was receiving treatment for a new medical condition. His new employer’s insurer denied coverage for this treatment as a preexisting condition. That left Monty without coverage for significant medical expenses.

Monty was unsuccessful when he sued his former employer under the Employment Retirement Income Security Act (ERISA) on the ground that it had not given him the required written notice about COBRA insurance coverage. Although it was through no fault of his own that Monty never received the notice, his former employer had made a good-faith attempt to get the written notice to him, and that was all that the law requires. The employer used certified mail, which is designed to enhance the prospects for an individual’s receipt of delivery, and it was not responsible for the letter going undelivered.

1 view0 comments

Recent Posts

See All

New HIPAA Rule

The U.S. Department of Health and Human Services has adopted a new rule concerning privacy and security for health information, to take into account changes that have occurred in health care since ena


bottom of page