Major health issue and hoping for input here;

13 years ago

Since I visit this forum the most, I am really hoping someone here can help me. I went out on sick leave that turned into FMLA leave back in April. After two months of testing was finally diagnosed with Pulmonary Hypertension and told I needed to apply for disability.

Before all the testing was complete FMLA moved into short-term disability and is now supposed to move to long-term. My employer held my position as long as they could and told me they were going to release me from my job at the end of August and send me everything I would need to elect Cobra insurance when my benefits ended with my job.

As of today, I still have not received any paperwork from the employer about Cobra and I am still covered under the company health insurance. In spite of multiple phone calls and emails from both myself and the case worker handling my disability claim, the employer still hasn't done their job about Cobra. This was also holding up getting the costly new meds I need to help with this disease. Since the insurance denied coverage for the meds, I was very fortunate to get placed on a temp no-cost 90 day program with the drug company and just received my first shipment of meds. But I really need to move to the Cobra asap.

I have gone as high as the Director of HR at my employer; and was promised that she would take care of this issue over a week ago.

Where do I go from here? Dept of Labor? Social Security?

Will be thankful for any and all thoughts.
Kat

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Comments (8)

dedtired
13 years ago
I would send copies of all correspondence with the HR department to your company's CEO or whoever is at the top. I bet a few words from The Boss will make the HR person snap to attention. After all, it costs the company more to keep you on their current roles rather than on COBRA.

Make sure every interaction you have with HR is documented via email. After speaking to her on the phone, send a follow up email "just to confirm our conversation".

I am so sorry that you are facing health issues. I do hope all is well soon.
triciae
13 years ago
I agree with Pam but would add to copy the CEO on all email correspondence in bold so HR can see that her boss is watching progress or the lack thereof. Also, don't forget to check the ACA as comparison to COBRA. I bet you can save some money. You can enroll now but, of course, coverage won't start until Jan. 1.

I'm sorry you're facing health problems. I hope this unneeded stress will settle down soon.

/tricia
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rob333 (zone 7b)
13 years ago
Contact your state insurance department telling them what youv'e told us. Address the top position, with a copy to your CEO and you'll have your paperwork faster than you can blink an eye. I worked in insurance for 18 years. These faxes went to the top of the pile very quickly. I'm sure they're emails now, but then, it was by fax.

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rosewitch
Original Author
13 years ago
Pam, Tricia and rob333,
Thank you so much for your help and good ideas. Since I posted I have received notice that the long-term disability claim has finally been approved. Along with the letter notifying me of this is tons of more paperwork to fill out due to a pre-existing provision that applies to the claim. Now they need to determine if I received treatment for the current illness during the 3 months prior to the date I was first covered under the plan. Most of the paperwork I have already filled out addressed the dates and times of my illness and it is clear that I have not been treated for this at any other time until now. But I will fill out the new paperwork and try to continue to be patient. But it's getting much harder.

Still nothing from my employer about changing over to Cobra and I am definitely going to follow up with rob's note about contacting the state insurance department and everyone's suggestion of including the CEO in everything from the beginning.

My employer is a 'nonprofit' that seems to make up the rules as they go along about a number of things. And I can't help but wonder how some of the admin people keep their jobs after seeing how they have not handled my issue along with some others that I have found out during this time. I am not the only employee dealing with a mess like this.

Well the saying is 'misery loves company'!

Also many thanks for the good health wishes. They mean a lot to me.
Will keep you posted.
Kat
lpinkmountain
13 years ago
How about a letter from a lawyer? I dunno how much that would cost but might help. Are there lawyers for such things? Or your state employment advocates?

I am so sorry you are having to go through all this. It's such irony that you have to do so much confusing paperwork when you are sick and trying to marshal your strength to fight the illness!

Keep up posted!
annie1992
13 years ago
Ah, Kat. I can't add anything to the advice, but I'm hoping that you get this all resolved. Paperwork seems endless, always, when insurance companies and disability claims are involved. (sigh)

I do hope you feel healthy soon.

Annie
rosewitch
Original Author
12 years ago
I took the posted advice and composed an email to the company CEO about this mess and copied in both the first HR employee that I was working with along with the HR director who was supposed to be following up and finding out why the delay.

I had also been playing phone tag with three different people at the labor board and was getting no help there. Seems no one really knew if they could help me. I had the state insurance dept lined up for my next step.

Before sending my email I tried calling one last time and finally reached a receptionist who understood how upset I was and why I didn't want anyone's voice mail and wanted to speak to someone in HR. It took her several tries and she kept putting me on hold but would come back to let me know what steps she was taking and to apologize for the wait. She finally was able to connect me to the original person that was taking care of things till she went out on her own FLMA leave and I quickly brought her up to date and told her that I was taking steps to go to the CEO and the labor board and the state ins dept.

Turns out she had turned over my paperwork to the HR director and after talking with me she put me on hold and went to see why nothing was done. Hello the paperwork was still just sitting on the director's desk!

She then tried to talk me into applying for Medicaid instead of Cobra because the Cobra is very expensive. I told her that I had Cobra once before and the cost should be the same that the company would pay if I was still employed. Main reason is by electing Cobra I will have no lapse in coverage and it should run until next year when I will have to find a plan on ACA.

It then took about 5 minutes top for her to send everything to Ceridian Benefits Services! Of course the issue now is that we are way pass the time limit of 45 days that an employer has to get the information to me to elect Cobra. And if I am denied because of this time lapse, my HR contact assures me she will make sure I get the coverage. We shall see. For sure I will be contacting the state ins dept if there is a problem and already have the info lined up and all my emails and forms ready to send to them.

What a bloody nightmare this has been.

One good thing is that the FDA has approved two new promising drugs in the last two weeks to treat Pulmonary Hypertension.

Thanks everyone, just being able to vent here has helped and your responses have made things easier for me.

Kat
tami_ohio
12 years ago
Glad to hear you are getting somewhere finally, hopefully. Sending prayers your way.

Tami

Major health issue and hoping for input here;

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dedtired

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