COBRA Insurance

[James I]

I recently took COBRA Ins(JAN) and had an operation on Jan 13, when the bills came in I found out my previous Employer downgraded my Ins. to what they call the Buy Down Option. The Out of Pocket expense had more than doubled and the Employee Benefit Security Admin.(EBSA) says an open enrollment in Jan changed my policy. The EBSA rules say I am to receive identical or similar to what I had before, there is still a policy offered by my previous employer for current employees that is almost identical to what I had. The EBSA handbook also says if a Open Enrollment is offered to current employee's I'm supposed to be offered the same(I wasn't).

Quote "The Dept of Labor does not interpret plan documents or determine whether individuals are entitled to benefits. That is the responsibility of the plan admin. or other appropriate plan official."(other words Employer)

This sounds like there is no policeman for X-employee's benefits?
IS THAT TRUE?

[Judge]

I recently took COBRA Ins(JAN) and had an operation on Jan 13, when the bills came in I found out my previous Employer downgraded my Ins. to what they call the Buy Down Option. The Out of Pocket expense had more than doubled and the Employee Benefit Security Admin.(EBSA) says an open enrollment in Jan changed my policy. The EBSA rules say I am to receive identical or similar to what I had before, there is still a policy offered by my previous employer for current employees that is almost identical to what I had. The EBSA handbook also says if a Open Enrollment is offered to current employee's I'm supposed to be offered the same(I wasn't).

Quote "The Dept of Labor does not interpret plan documents or determine whether individuals are entitled to benefits. That is the responsibility of the plan admin. or other appropriate plan official."(other words Employer)

This sounds like there is no policeman for X-employee's benefits?
IS THAT TRUE?


It looks like your employer violated the law. Get an attorney. If you win he can get attorney fees for you paid by the employer.

[Juliete Davis]

Judge is correct. But there are other policemen, namely the IRS and DOL investigators (http://www.cobrahealth.com/governmentcontacts.htm) ready to help you. The hold times can be long. You must be offered the same coverage as active employees, did they send you documents during open enrollment, or did they just choose for you? I am thinking that if you got the docs and did not respond by a certain date, your plan would be downgraded.