Ensuring Continuous Health Coverage: An Update on My Experience with Employer-Sponsored Insurance and COBRA Challenges
Navigating health insurance post-employment can sometimes be more complicated than expected. I want to share a recent update regarding a situation I previously discussed concerning my former employer and my ongoing health coverage.
Background Context
Since parting ways with my former employer in 2020, I maintained a state Medicaid plan that has served as my primary health coverage. During that time, my employer’s sponsored health insurance was active, but I was no longer employed there. Despite my departure, my employer’s benefits team did not process my termination from their insurance plan, and I remained enrolled without my knowledge or consent. This oversight led to a series of complications, especially once I discovered the oversight through official correspondence.
Recent Developments
A few months ago, I received official notification indicating that my employer-sponsored health plan was terminated, effective approximately six months prior—around fall 2024. The notice also informed me I was eligible for COBRA continuation coverage from that date forward. This was a relief in some respects, yet it raised new questions and challenges.
Consequences of the Delay
Shortly after, I began receiving billing notices from healthcare providers, informing me that payments had been reclaimed. Many of these bills were too old to re-submit to Medicaid, leaving providers in a difficult position. Thankfully, most of these providers do not bill Medicaid recipients directly, but the situation was still unjust—an undue burden on the healthcare providers who provided services during that period.
Legal Assistance and Resolution Efforts
To address these issues, I engaged with a nonprofit healthcare legal organization. Their expert assessment confirmed that, under federal regulations, an employer cannot retroactively cancel health insurance coverage unless specific, narrow circumstances—such as fraud—are involved, which did not apply in my case. They also identified a violation of federal COBRA notification requirements: my former employer had failed to notify me promptly about my eligibility for continuation coverage, and they sent me a confusing letter indicating COBRA eligibility six months too late for me to act.
The nonprofit legal team is now representing me. They are actively working to ensure my healthcare providers are paid, and they are investigating whether I am entitled to compensation for the inconvenience caused by the employer’s non-compliance.
Conclusion
While my Medicaid coverage remains intact and primary, this experience highlights the importance of vigilance when it comes to employer-sponsored health insurance, especially during transitions. It also underscores the value of consulting legal
