Want to use COBRA but Ex won't help

[Davnasty]

I've been trying to help a friend out with getting onto COBRA health insurance but we've reached an impasse.

She recently divorced and would like to stay on her ex's employer's plan. Everything I've read suggests this should be allowed, but the tricky part is getting any information about the plan. The employer, the insurance company, and the COBRA specialists (iTedium*) all say they can't tell her anything without the ex's permission. Unfortunately he's not cooperating.

My question, is there anyway to get information about her current plan and sign up for COBRA without his permission? How would one even sign up when no one can tell you anything? It seems insane to me that someone has a right to use COBRA but no right to any of the information about their plan.

*Whoever named this company has a sick sense of humor :)

[yachi]

I've been trying to help a friend out with getting onto COBRA health insurance but we've reached an impasse.

She recently divorced and would like to stay on her ex's employer's plan. Everything I've read suggests this should be allowed, but the tricky part is getting any information about the plan. The employer, the insurance company, and the COBRA specialists (iTedium*) all say they can't tell her anything without the ex's permission. Unfortunately he's not cooperating.

My question, is there anyway to get information about her current plan and sign up for COBRA without his permission? How would one even sign up when no one can tell you anything? It seems insane to me that someone has a right to use COBRA but no right to any of the information about their plan.

*Whoever named this company has a sick sense of humor :)

I think someone is giving you wrong information.  The below quote is from website of a divorce and family law practice.

To be eligible for COBRA post-divorce, either the employee or non-employee spouse must get in touch with the group health plan administration and let them know about the divorce or separation. If this is not done within 60 days after the legal end of the relationship, COBRA rights won’t be recognized.

[Raenia]

Even if she should legally be eligible, I'm not sure what recourse she has if the plan administrator refuses to speak to her. Perhaps having a lawyer send a certified letter would help, but that may cost more than it would save.

[Dee18]

Here is basically the same information, found at the official government website:
https://www.dol.gov/sites/dolgov/files/ebsa/about-ebsa/our-activities/resource-center/faqs/cobra-continuation-health-coverage-consumer.pdf

Is she within the 60 days?  That's a pretty short time frame.  If so, she could have her attorney call right away or she could send a certified letter (overnight if necessary to meet the 60 day limit) stating she wants to enroll in Cobra and understands she has the legal right to do so. 

My young adult daughter is now an HR manager at a company.  She is doing her best, but learning as she goes.  I would not be surprised if someone on the other end simply doesn't know the rules.  Or perhaps she asked for information about the Ex's insurance, which might under some rule be protected private information, rather than specifically saying she wants to be on Cobra.  (If it turns out the cost is too high, she can simply not go through with it.)

[Davnasty]

Here is basically the same information, found at the official government website:
https://www.dol.gov/sites/dolgov/files/ebsa/about-ebsa/our-activities/resource-center/faqs/cobra-continuation-health-coverage-consumer.pdf

Is she within the 60 days?  That's a pretty short time frame.  If so, she could have her attorney call right away or she could send a certified letter (overnight if necessary to meet the 60 day limit) stating she wants to enroll in Cobra and understands she has the legal right to do so. 

My young adult daughter is now an HR manager at a company.  She is doing her best, but learning as she goes.  I would not be surprised if someone on the other end simply doesn't know the rules.  Or perhaps she asked for information about the Ex's insurance, which might under some rule be protected private information, rather than specifically saying she wants to be on Cobra.  (If it turns out the cost is too high, she can simply not go through with it.)

Yes, it's only been a couple weeks, she'll talk to her attorney next week. I'm hoping that sorts it out but like you say, 60 days isn't much so best to pursue multiple avenues at once rather than sit around and wait. Being told bad or incomplete information is a concern. I did suggest calling back to talk to a different customer service rep and starting over from the beginning with the hope of getting someone more helpful.

The ex said he had already notified the insurer and her coverage would end on 4/30, and that was incorrect. Insurer told her their was no end date for her plan but that's basically the only information they were willing to give.

[EchoStache]

I don't think COBRA is any great benefit.  AFAIK, it's basically like getting ACA marketplace insurance with zero subsidy i.e. expensive.  She might be better off just getting a marketplace policy if she doesn't have a job/income.  If she does have a job that offers health insurance, in most cases it should be signifantly cheaper than COBRA.

[ixtap]

I don't think COBRA is any great benefit.  AFAIK, it's basically like getting ACA marketplace insurance with zero subsidy i.e. expensive.  She might be better off just getting a marketplace policy if she doesn't have a job/income.  If she does have a job that offers health insurance, in most cases it should be signifantly cheaper than COBRA.

It depends on actual costs and what the available plans cover. Particularly for someone who has already met their deductible for the year, COBRA can be an excellent choice.

[EchoStache]

"If you become divorced or legally separated from the covered employee, or if a dependent child no longer meets the requirement to be a covered dependent (usually by reaching a specified age), the covered employee or qualified beneficiary is responsible for notifying the plan administrator of the qualifying event within 60 days after the date of the qualifying event.

Q12: What is the next step in the process once appropriate notice of a qualifying event is given to the health plan administrator?

Plan administrators that receive notice of a qualifying event must notify qualified beneficiaries of their right to elect COBRA coverage.  Qualified beneficiaries have independent election rights, and therefore they must each be notified.  If all the qualified beneficiaries reside at the same address, the plan administrators may either include separate election notices for each qualified beneficiary in a single mailing that is addressed to both the employee and spouse, or send a single notice that  clearly identifies all qualified beneficiaries covered by the notice, and explains each person's separate and independent right to elect COBRA continuation coverage.  Each qualified beneficiary then has 60 days to decide whether to elect continuation coverage."

https://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/cobra_qna#:~:text=If%20you%20become%20divorced%20or,of%20the%20qualifying%20event%20within

Might still be a better option to go with marketplace depending on circumstances.  They even offer 0 deductible plans.

[ixtap]

The sixty days starts from when you receive notification. If the spouse has done their bit and notified their employer, then the employer has a few weeks to notify the benefits coordinator, the benefits coordinator has a few weeks to inform the covered, and the covered has sixty days from this coverage letter.

COBRA is not an easy process for those of us who like to just get things taken care of. You have to wait for everything to work it's way through the system. One thing that finally helped me accept it was realizing that they were legally obligated to get me the information. The employer and the benefits admin will work it out and as long as you meet your deadlines, it will come together and be retroactive.

[Davnasty]

I don't think COBRA is any great benefit.  AFAIK, it's basically like getting ACA marketplace insurance with zero subsidy i.e. expensive.  She might be better off just getting a marketplace policy if she doesn't have a job/income.  If she does have a job that offers health insurance, in most cases it should be signifantly cheaper than COBRA.

It depends on actual costs and what the available plans cover. Particularly for someone who has already met their deductible for the year, COBRA can be an excellent choice.

Yes, some deductible has been met and they're right in the middle of a bunch of diagnostic work and possible procedure. Still unclear if COBRA is the best option but it's likely a good short term option.

Also, they are self employed and making too much to qualify for any subsidy.

[Davnasty]

"If you become divorced or legally separated from the covered employee, or if a dependent child no longer meets the requirement to be a covered dependent (usually by reaching a specified age), the covered employee or qualified beneficiary is responsible for notifying the plan administrator of the qualifying event within 60 days after the date of the qualifying event.

Q12: What is the next step in the process once appropriate notice of a qualifying event is given to the health plan administrator?

Plan administrators that receive notice of a qualifying event must notify qualified beneficiaries of their right to elect COBRA coverage.  Qualified beneficiaries have independent election rights, and therefore they must each be notified.  If all the qualified beneficiaries reside at the same address, the plan administrators may either include separate election notices for each qualified beneficiary in a single mailing that is addressed to both the employee and spouse, or send a single notice that  clearly identifies all qualified beneficiaries covered by the notice, and explains each person's separate and independent right to elect COBRA continuation coverage.  Each qualified beneficiary then has 60 days to decide whether to elect continuation coverage."

https://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/cobra_qna#:~:text=If%20you%20become%20divorced%20or,of%20the%20qualifying%20event%20within

Might still be a better option to go with marketplace depending on circumstances.  They even offer 0 deductible plans.

Thanks, this is really helpful. Much more detailed than most of the sources I've been able to find.