Kokua Line June Watanabe

COBRA benefit eligibility has limitations

Question: As an employee who just got laid off, I was told by HMSA that the COBRA has to be processed by my former employer. My former employer refused to do the paperwork. What are my options or rights?

Answer: Since you did not leave a name or contact information, we do not know who your employer was and what the circumstances are of the refusal to "do the paperwork" for COBRA (Consolidated Omnibus Budget Reconciliation Act).

The act gives certain former employees and their families temporary continuation of health care coverage under group rates.

We're assuming you worked for a private employer, in which case you can call the U.S. Department of Labor's Employee Benefits Security Administration toll-free at (866) 444-3272.

Or send a letter to U.S. Department of Labor, Employee Benefits Security Administration, Division of Technical Assistance and Inquiries, 200 Constitution Ave. NW, Suite N-5619, Washington, D.C. 20210.

You can find out more about COBRA at http://www.dol.gov/.

It may be that you do not qualify for COBRA coverage.

Only employers with 20 or more employees are obligated to provide the coverage with notice of a "qualifying event," points out Cliff Cisco, senior vice president of HMSA.

Employers of 20 or more people must notify the health plan if a covered employee is terminated or has a reduction in work hours; the employee has died or become entitled to Medicare; or if the employer goes bankrupt.

If so, the employer has 30 days after the event occurs to give notice.

If you were a covered employee, you should have received notices explaining what your COBRA rights are, how it is offered, etc.

If a company declares bankruptcy and folds, COBRA may not be available.

In the case of Aloha Airlines, former employees are able to access COBRA until there are no Aloha employees enrolled in the group plan, Cisco explained.

"As of this date there are still a few Aloha employees engaged in the closing down of the company," he said yesterday.

"Once the last employee is no longer covered by the health plan, COBRA coverage terminates."

That's expected to occur soon.

However, HMSA has requested approval from the state Insurance Commissioner for an "Extended Benefit Program" specifically for former Aloha employees who have lost COBRA coverage, Cisco said.

That request is still pending.

Mahalo

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