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Can an employer require an employee to seek help from EAP?
Additional Details
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Momma K | Husband lost job and I'm pregnant is the Insurance co. required to cover until delivery? |
I'm trying to apply for state insurance at the moment, but lots of people I talk to are telling me that since the Insurance Company covered me before they can't cancel while I'm still pregnant. (I'm due in 7 weeks) or is that what the consider the Cobra plan. Which they want us to pay $1300 a month for Cobra. I'm confused, should they still cover me w/out Cobra or not. Anyone with knowledge in this area, I'd appreciate any input. |
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shjOlds_442
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Insurance companies HATES their customers! If their is any type of loophole they can find to get out of paying you, they will!
If you think that's just my opinion, just as the people who lived around New Orleans! |
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woman01234
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i think you have to pay for the cobra for you to be covered. they will reimburse you for medical expenses since your coverage ended. the insurance should only last til the end of the month that your husband left the company. pay the cobra it is cheaper than no insurance and im sure you dont want to deliver at a county hospital. |
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sweddishsam
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it all depends on your policy, you should read it very carefully, if you have supplemental insurance you should be fine.. sorry to hear of your troubles.. cobra is typically a short term inbetween company (jobs) insurance program.. but who can pay 1300 without a job..COBRA contains provisions giving certain former employees, retirees, spouses and dependent children the right to temporary continuation of health coverage at group rates. This coverage, however, is only available in specific instances. Group health coverage for COBRA participants is usually more expensive than health coverage for active employees, since usually the employer formerly paid a part of the premium. It is ordinarily less expensive, though, than individual health coverage.
The law generally covers group health plans maintained by employers with 20 or more employees in the prior year. It applies to plans in the private sector and those sponsored by state and local governments.{2} The law does not, however, apply to plans sponsored by the Federal government and certain church- related organizations.
Group health plans sponsored by private sector employers generally are welfare benefit plans governed by ERISA and subject to its requirements for reporting and disclosure, fiduciary standards and enforcement. ERISA neither establishes minimum standards or benefit eligibility for welfare plans nor mandates the type or level of benefits offered to plan participants. It does, though, require that these plans have rules outlining how workers become entitled to benefits.
Under COBRA, a group health plan ordinarily is defined as a plan that provides medical benefits for the employer's own employees and their dependents through insurance or otherwise (such as a trust, health maintenance organization, self-funded pay-as-you-go basis, reimbursement or combination of these). Medical benefits provided under the terms of the plan and available to COBRA beneficiaries may include:
Inpatient and outpatient hospital care
Physician care
Surgery and other major medical benefits
Prescription drugs
Any other medical benefits, such as dental and vision care
hope this helps, and good luck!! Sam. |
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Insurance Biz CT
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There is no requirement for the Insurance Company to cover you because you are pregnant. Your husband's employer has an obligation to offer you continuation of coverage. You will not be covered unless you elect continuation.
At this point, being due in 7 weeks, I don't think you have many options for purchasing coverage, except COBRA, or State Continuation. COBRA coverage is simply the same coverage that your husband currently has, but instead of his former employer paying a portion of the premium, he would be responsible for all of it plus 2% allowed by law for administrative expenses on the part of the employer. While individual insurance may be a bit less expensive, it may not cover maternity, however, if it does cover maternity, with evidence of prior coverage within the last 63 days, it cannot be considered a "pre-existing condition."
If you cannot afford the $1300 per month premuium, especially considering that your husband has just lot his job, you can check with your local Social Services Office to see what programs you may be eligible for that will cover you and your family, including the delivery of your child. In CT, we have the HUSKY program. I believe every state has similar programs to provide health care to families, especially children, and pregnant women who do not have insurance.
Look at all options before making a decision, but don't wait too long. You have a defined period of time to elect continuation of coverage.
Good luck to you and your family. |
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Heather K
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From what I understand about insurances, usually after a person is terminated from their employer, the insurance usually cancels within 30 days. Then they will send you some info about the COBRA plan which is outrageaous. Your best bet is to go apply for help with the state like you said, they will pay for the remander of your pregnany, dont stress it will work out. But the insurance companies dont have to cover you after 30 days from termination of employment. Early Congrats on the new baby. |
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mbrcatz
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No, they are required to cover until the premium stops getting paid - if you guys elect to take COBRA coverage, and pay it every month on time, it will continue. If you don't, the coverage lapses.
There's no grace period with COBRA. So I'd be sure to pay at least the next two months. |
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zippythejessi
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I believe that if you don't accept the COBRA coverage, you're no longer covered. $1300 a month seems a little high - it's usually just a little over what you'd pay as an employee (unless the employer was picking up all of the cost, in which case, you'd be paying a little more than the employer was.)
If you were already in the hospital and your insurance canceled midway thru your stay, then the insurance would cover you under what's called Continuity of Care, but I don't beleive that applies here. |
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Ms Gia
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Look Take it from a mother that has been on the state insurance since I had kids, The states coverage is way way better. If that was your only income you cannot pay that save your money. They State ask you a lot of personal questions about your income and bank info and I never supply my personal info with them because the help you less, So hurry and apply for emgency assitance and they will help your only for temporray reason. Since your husband is not working its better to have it covered by the state because they pay for every thing and even if you had a job like me if you cannot afford the insurance you can still get it from the state with a sliding fee!
In your sistutation the State Medical is not a hassel and Stay on them to help you in your sistution, and even after the baby is born the will help with the other cost of labor and after birth, Don't let it stress you because thats what the state is for to Help OUT! |
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Jan C
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First, you are totally confused about the cost of Cobra insurance. Call the employer for an amount. Additionally, you will get an offer to continue carrying it and they will tell you the monthly charge. Yes, if you don't pay they will cancel you. There isn't anything free. |
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