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Compliance September 1, 2005
Judge: Oral COBRA Notice Legally Sufficient
September 1, 2005 (PLANSPONSOR.com) - A Michigan man
suing his former employer over his health coverage won a
mixed legal victory when a federal judge cleared the
engineering firm of wrongdoing on one issue but paved the way
for more proceedings on another.
Reported by Fred Schneyer
US District Judge Robert Holmes Bell of the US District Court for the Western District of Michigan ruled that Dreisenga & Associates had satisfied the notice requirements of the Consolidated Omnibus Budget Reconciliation Act (COBRA).
Even though President Daniel Dreisenga did not specifically refer to COBRA in his conversation with plaintiff Thomas Joiner, the interaction with Joiner allowed him to make an informed decision about his ability to continue coverage after he retired, Bell said.
According to Bell, Joiner and Dreisenga discussed continuation of coverage and agreed Joiner would be responsible for the premium. This notification allowed Joiner to make an informed decision, the court said.
While Dreisenga “may not have specifically referred to [Joiner’s] continuation coverage as a benefit conferred under COBRA, the notice given adequately informed him of his ability to continue coverage. Thus, [Joiner] was able to elect to continue coverage that would otherwise terminate due to his retirement. In short, through [Dreisenga’s] notification and continuation of [Joiner’s] coverage, the purpose of COBRA was served,” Bell wrote in his opinion.
However, Bell refused to dismiss the remainder of Joiner’s case alleging that Dreisenga violated the Health Insurance Portability and Accountability Act (HIPAA) by terminating his coverage after learning he had prostate cancer. Bell said because there was conflicting testimony about how long Joiner was supposed to be covered and whether the employer was informed of the cancer before or after it terminated insurance coverage, Joiner had the right to keep that part of the case alive.
The company alleged that Joiner was entitled to coverage only until age 65 and that it notified Joiner it was terminating his coverage before he informed them he had cancer. Joiner asserted that the agreement on continued coverage did not have a specific termination date and that he notified the company of his cancer before the termination of coverage.
The case is Joiner v. Dreisenga & Associates Inc., W.D. Mich., No. 1:04-CV-437, 8/29/05.