Have you been denied COBRA insurance benefits by your former employer in Florida?
You could be owed up to $110 per day from your employment benefit plan…
The Department of Labor (DOL), under ERISA, mandates employers properly notify covered employees of their benefits within a specified time frame.
If your former employer failed to provided proper COBRA documents within the required time frame you may be owed.
The law requires that COBRA be offered to employees when certain conditions are met.
If you think that you have been unlawfully denied your health insurance benefits after losing your job, you should speak to a lawyer.
Below, you can learn more about how the law works, who is eligible, and what may happen if you are denied your rights.
Let’s review the COBRA program.
What is COBRA (The Consolidated Omnibus Budget Reconciliation Act)
COBRA is a federal law that gives workers on employer health plans the right to maintain group health benefits after a career or family event that adversely affects their eligibility.
This right only applies in certain situations. For example, you may be able to maintain your health insurance if you lose your job, switch jobs, or have your hours reduced by your employer.
You may also be able to maintain your benefits if you would lose them to do life events involving partners whose benefits cover you, such as death and divorce.
You may be able to maintain many different kinds of coverage under COBRA. For example, health benefits, dental benefits, and even vision benefits from your employee health plan can be kept for a limited period of time.
Before you apply for COBRA, you should determine your eligibility.
Who is Eligible for Florida COBRA insurance?
To be eligible for COBRA, you must be a qualifying beneficiary. The following conditions apply:
- The employee group health plan must have previously covered you
- You must have been on the plan for at least 50% of the business days in the prior calendar year
- Your employer must have more than 20 employees in its group plan
While the law provides comprehensive protections, it is possible to lose your eligibility. For example, you may not be able to apply for COBRA insurance in any of the following situations:
- Your employer cancels the group health insurance plan
- You fail to pay the plan premiums
- You apply for and are enrolled in health insurance provided by a new employer
- You apply for and are enrolled in Medicare
- You participate in any fraudulent activity such as filing false claims
When should employees provide COBRA election notice?
Notice for employment changes
If you are eligible for COBRA, your employer or plan administrator is required to provide you with an election notice as soon as your employment status changes.
Employers and plan administrators are required to meet strict federal standards for providing COBRA notice in Florida.
Any employer subject to COBRA requirements must notify the administrator of the group health plan within 30 days after a change in employment results in a change in the employee’s eligibility.
The plan administrator has 14 days after they are notified to give the employee notice of their COBRA rights.
In some cases, the employer will be the administrator of the plan. In those cases, the employer is responsible for notifying employees of their rights. Employers who administer plans must provide COBRA notices directly. They have 44 days to send employees the election notice.
Notice for life events
If you experience a life event that changes your eligibility for employee health insurance, such as a death or divorce, you are responsible for notifying the plan administrator. You have 60 days to report the qualifying event to the plan administrator.
Penalties for failure to provide COBRA notice in Florida
Employers are required to provide notice to employees when they have the option to choose COBRA to continue their coverage. Employers who fail to do so may have to pay a penalty of $110 for each day that the notice is not provided.
Employers may also be responsible for the medical costs incurred by the qualified beneficiary while COBRA did not properly cover them.
Employees who are not provided with notice may have the option to sue the employer or plan administrator who was responsible for sending the notice. In these cases, the employer may be required to pay the attorney fees of the employee and additional damages decided by the courts.
You may have received a notice claiming that you are not eligible for COBRA coverage (or failed to receive notice at all). These actions may result from an error, so you need to know what to do if you have been denied.
What should I do if I’m denied COBRA coverage?
Your employer or plan administrator may have violated your rights if:
- You were never sent a COBRA notice despite eligibility
- You have not received the plan documents you requested within the deadline
- The notice you received is missing the required information that you need to sign up for COBRA coverage
- The notice you received is not written to be understood by the “average plan participant”
If any of this has happened to you, start by speaking to an employment lawyer. Under ERISA you may be owed up to $110 for each day they failed to provide you the proper documents required by law. A lawyer can help you verify your eligibility, claim penalties that are owed to you or represent you in court if your employer is wrongfully disqualifying you.
Get justice for denied COBRA coverage
Now, you understand more about how COBRA works. You know what COBRA is, who is eligible, and when the notice should be provided. You also know what types of penalties may be involved if your employer fails to meet their obligations and what to do first if you’re denied coverage.
Do you believe that you have been unlawfully denied COBRA coverage? Speak to an employment lawyer as soon as possible. The earlier you reach out to a lawyer, the easier it will be for you to find justice.