Following is an email I sent to employee@whji.com, allegedly someone from whom I can get some answers.
“Please note well item six in the following paragraph (italics mine):
“Termination of COBRA Continuation of Coverage: The law also provides that your continuation of coverage may be terminated for any of the following reasons:
1. Whitehall Jewelers no longer provides group health coverage to any of its employees;
2. The premium for your continuation of coverage is not paid on time;
3. You become covered under another group health plan, unless the plan contains any exclusions or limitations with respect to any pre-existing condition you or your covered dependents may have; (see Duration of COBRA continuation section, below);
4. You become entitled to Medicare;
5. You extend coverage for up to 29-months due to your disability and there has been a final
determination that you are no longer disabled;
6. Bankruptcy of Whitehall Jewelers.”
“Since Whitehall is indeed in bankruptcy proceedings, what am I supposed to do about my COBRA coverage, which was supposed to start September 1st? I called and spoke to someone named Susana on the 3rd, since I had not yet received my packet, and she said that she would be sending it out ‘right away.’ I told her that I was concerned about there being a lapse in coverage and she told me not to worry, that COBRA is retroactive and that I ‘could just pay out-of-pocket until my coverage reinstated.’ I told her that it would be at the very least, hundreds of dollars in medication costs and that I could not ‘just pay out-of-pocket until my coverage reinstates.’
“On the 23rd, I called again, and spoke to someone named Liz since I had still not received my packet. She said that she would look into it. She called me back the next day and said that they would be sending it out ‘right away.’ She called me again and left a voice mail for me that if I wanted the packet emailed to me, I could have that done. When I went to the pharmacy on the 28th to pick up two prescriptions, the pharmacist handed them to me with a total of over eleven hundred dollars. Eleven hundred dollars. He said, ‘Your coverage expired August 31st.’ Interesting to me, since I had given my notice on August 4th with my letter of resignation and end date of the 10th, giving you all more than enough time to get out my COBRA packet for there to be no lapse in my coverage. I was able, with a Prescription Savings Card, to get the total amount due down to the paltry sum of $875.83. Mind you, I cannot live without these medications, and they are not the only two I take.
“At 9:15 am on the 30th, I spoke to someone (I neglected to get their name) who told me that in order to get reimbursed for the $875.83, I was going to have to fork over another $912.81 per month for every month that I want my husband and I to be covered under COBRA. That total is more money that I bring home in a month. Even if I work very, very hard and sell lots and lots of jewelry, that’s still a very hard number to come up with. And on top of that, I still end up paying over $200 out-of-pocket for medication. With insurance.
“Today, I printed out the email with the attached pdf file with the COBRA packet (I have yet to receive the paper copy — will I ever? I’m guessing not at this point) and read this line: ‘Your health plan coverage provided to you and your family by Whitehall Jewelers will be terminated as of 08/10/2008 due to Termination.’ As stated above: I gave notice on the 4th with intent to leave on the 10th. Why am I only now receiving this packet AT MY BEHEST OVER A MONTH LATER? If you people had done your job and sent out the packet on time, I would not have to had lay out $875.83 for two prescriptions and I wouldn’t have this lapse in coverage. I have to go to the pharmacy again in about a half hour, and it is going to cost me another $199.73. I guess I can ‘just pay out-of-pocket until my coverage reinstates.’ And forget about groceries for dinner tonight.”
