COBRA
COBRA, for those of you who have never taken any interest in your health insurance, is a Federal law that allows you to continue your employer goup health/dental/vision/FSA coverage at the group rates after your are not longer normally eligible (due to, for instance, termination of employment, reduction in work hours, divorce, being too old to stay on your parents' coverage, etc). COBRA premiums are high ... I am not denying this ... but it's generally much cheaper than getting equivalent coverage through an individual policy, and the reason the premiums usually look so high is because while you're working, most employers subsidize at least part of your premium, whereas you have to pay all of it (up to 102% of the total premium for active employees) when you're on COBRA.
Not terribly long ago, COBRA was amended for the billionth time, and COBRA administrators can't termintate your coverage if you have paid less than the full premium, as long as the difference is "insignificant." My company defines "insignificant" as $5, which is more generous than most places, lemme tell you.
Now, once people learn this, they for some reason think that they can get away with just paying less than the full premium every month! And just send in whatever the hell they feel like paying. Um ... it doesn't work like that, your coverage won't be terminated due to an insignificant difference, but that doesn't mean your claims will continue to get paid while you're underpaid on premiums. And those small amounts of money will add up over several months ... we're not writing off those insignificant amounts, you still friggin' owe them and they are made up each month out of the short premiums you send in for the next month, so the only person you are shortchanging is yourself.
"Termination" in COBRA law means "your coverage has been cut off and you have no hope of reinstating it, have a nice life." The fact that we're not paying claims while people are back on premiums looks kinda like termination, but it isn't. Believe me, it isn't.
Well, on Wednesday I had a guy call because he hadn't been able to pick up his prescriptions in April while he was electing COBRA, and now that he'd elected it and paid his premium, he still couldn't get reimbursed for the prescriptions. I checked the payment screen - for the month of April, he was underpaid by $.35.
Now, 35 cents isn't much! But by god, it's less than the full premium, and if he got more than 30 days overdue for May's premium, coverage would be termed retro to the first of April. I dunno what makes people think that they can just invent their own premium like this ... His coverage hadn't been terminated, he still had a chance to pay that back 35 cents, but of course we weren't going to reimburse prescriptions while he wasn't paid up.
I explained this to him, and any consideration I might have had for the possibility that he just made a mistake when making out his check was dashed to pieces when he said, "I did that because I know you can't terminate my coverage for an insignificant difference!"
...
What kind of nutjob deliberately plays games with an insurance company over thirty-five freakin' cents??
Eventually, after telling me that this was no way for us to do business, and that he had hundreds of dollars in prescriptions and he needed that money back (obviously not as much as he needed that 35 cents!), and trying to force me to take it via credit card over the phone (we're not set up to accept cards of any type, and swearing at me will not make credit card capability magically appear), he finally asked who he had to write to to complain about this.
I told him, "The United States Congress."
Sometimes I love COBRA.
Current Mood: moody
Current Music: Unerasable Sin