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Post-Employment Insurance: Your Rights Under COBRA


Counsel Comments:Cases typically pit a former employee or an employee's dependent with substantial medical expenses against the employer or an insurance company. Courts are sometimes willing to interpret and apply COBRA with a view toward extending coverage wherever possible. For example, in one case, an employee incapacitated by a series of strokes was maintained on her employer's group insurance policy. After about a year, the employee was taken off the company's rolls. At that time she was in a coma, and the COBRA continuation notice was sent to her husband. Misunderstanding the intent of the offer and thinking that his wife was still covered under the employer's group plan without premium payments, he waived his wife's insurance continuation rights. Later, as legal guardian, the ex-employee's husband tried to regain the option of COBRA coverage, but the insurance company refused. The husband sued and won; the court ruled that the employer should have included the Summary Plan Description with the COBRA notice sent to the husband and that without the summary he was unable to make an informed decision.

Tip:Know your COBRA rights before accepting any job and in the event you resign or are fired. This is especially true if you or a spouse or dependent is sick and needs the insurance benefits to pay necessary medical bills. You are entitled to such protection even if you have worked for the employer for a short period of time. Most short-term employees can generally enjoy COBRA protection for periods exceeding the length of their employment. The only requirement is that you must have been included in the employer's group plan at the time of the firing and that the employer was large enough (i.e., employed 20 or more workers, including part-timers, independent contractors, and agents, during the preceding year) under federal law to qualify.

You cannot obtain benefits if you are fired for gross misconduct. This term is relatively ambiguous; the burden of proof is on the employer to prove that the discharge was for a compelling reason (such as starting a fight or stealing).

Copyright 1998 Steven M. Sack

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