Employer VS Third Party Cobra Admin company responsibilities? (timeline)
So. I think I am going to send this timeline as an email. But I am happy to take other advice if anyone has any.
November 2024
Nov 18: Terminated. Nov 30: My insurance with Blue Cross Blue Shield (BCBS), Cigna Dental, and VSP Vision officially ends.
December 2024
Dec 13: I email HR at [previous employer] to follow up to ensure I receive Cobra paperwork before I leave for my trip as I will be gone for a while. They ensure that it’s escalated with [3rd party company]. Dec 20: I cash pay for my prescription. My prescription total is $579.74. Luckily, I found a good RX, which dropped it to around $50. Dec 24 – Jan 17: I travel out of the country.
January 2025
Entire month of Jan (some of Dec): As I attend doctors visits, I get told that my insurance is inactive. I state to all of them that I have sent in my paperwork and payment for Cobra and it will be reenacted soon. Late January: After returning home, I finally receive my Cobra election paperwork, listing: BCBS for medical, Cigna for dental, and VSP for vision. I submit paperwork and payment ($XXXX) to cover December, January, and all of February to avoid a coverage gap.
February 2025
Feb 4: I attempt to attend an appointment with [doctor]. The office asks me to cancel due to insurance showing as inactive and to call back when I figure it out. I tell him that my Cobra will be enacted soon, but he asks to wait to avoid billing problems. I call [3rd party company]—they confirm receiving my paperwork, payment, and all three plans: VSP, Cigna, and BCBS for my medical. She stated that it may be that they just got the payment and it may take time to process. Feb 4 (same day): I call BCBS directly. They cannot find any record of my Cobra coverage. BCBS contacts [previous employer] on my behalf, who informs them I only enrolled in dental and vision and that they show that I did NOT elect medical coverage, and actually show that I opted out of—which is incorrect. [Previous employer] also mentions prior to hanging up with BCBS, that they “don’t have BCBS anymore” and that they switched to Cigna. Feb 4 (afterward): I call [3rd party company] back and inform them of the discrepancy and that [previous employer] doesn’t have BCBS anymore. They realize the health insurance provider changed but never sent me new open enrollment options. [3rd party company] emails me my actual options for 2025 (Please note: None of these plans are comparable to my old plan, which is fine if I was given the opportunity to know. However, if my doctors did not take Cigna and if I wanted to look at further options, whoever’s ([3rd party] or [previous employer], I’m unsure?) actions have put me outside of my special enrollment period with the marketplace. Feb 5: I email [3rd party company] back confirming the Cigna plan I choose. (I am so lucky that most of my health team in fact takes Cigna.) In addition, I ask them to enact in urgently, as I am already behind on my medication. Feb 6: My coverage is emergency-enacted and I am given the ID number and group number to give to offices. Feb 8: I go pick up my medicine and I am unable to as it needs a prior auth. My pharmacy submits a prior authorization request for my medication, and I pay out of pocket for a weeks worth to hold me over. Today, Feb 19: I finally receive my insurance card and discover I was enrolled in the wrong plan. One that has a higher deductible and lower coverage. Additionally, I called the pharmacy today and they still do not have a prior authorization, and now I am unsure if I want to bug Cigna about it just yet, in the case I switch plans again and have to get another. My doctors appointments (at least from Dec’s) have started going to collections due to this insurance mix up and extended wait time.
It just blows my mind that here I am, on Feb 19th, still struggling to get medicine from insurance I had through I job I lost in NOVEMBER and am still unable to.
When I first spoke to [3rd party] on February 4, I was told I had BCBS coverage, but that turned out to be false. Had I not followed up, I would still be waiting for insurance that no longer existed. When I spoke to [previous employer] that same day, she claimed I had no medical coverage at all, which was also incorrect.
Ultimately, my original BCBS plan was discontinued without official notice. I was never given new plan options in time to make an informed choice during my qualifying life event period. And now, after all of this, I have been enrolled in the wrong Cigna plan.
I have chronic health conditions, and maintaining insurance (particularly my original BCBS plan) was critical. I am paying out-of-pocket for medication and receiving notices and maybe- all it takes is one button to switch me from the PPO to the EPO – but I feel so incredibly frustrated.
I was going to send a mass email to [3rd party] as well as [previous employer] as I don't know what the third party technically does or whose fault all this is.
submitted by /u/Equal-Butterfly1219
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