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Association of
Ameritech/SBC Retirees
Association of Ameritech/SBC Retirees
Blue Bulletin - Vol. 2, No. 8 Posted
June 2, 2007
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Association of Ameritech/SBC Retirees Blue
Bulletin Vol. 2, No. 8.
(June 1, 2007)
Proudly representing
retirees from the new AT&T Midwest Region, SBC Midwest Region,
Ameritech, as well as the five Bell Companies in Illinois, Indiana,
Michigan, Ohio, and Wisconsin
Medical Coverage Bulletin - COBRA
“COBRA COVERAGE – YOU
THINK YOUR DEPENDENT IS COVERED – BUT BE CAREFUL. THAT MIGHT NOT BE
THE CASE – YOU MAY NEED TO TAKE ACTION – If you have a dependent
student that is transitioning from High School to College (or
College to a Masters program), be sure that s/he is accepted as a
student prior to the normal 60
day expiration window for applying for COBRA
coverage. Timing, according to COBRA events, apparently means
everything! If things don’t pan out and the dependent ends up not
being accepted or for some reason s/he does’t go to school because
of some unexpected event, it is likely that
s/he may not be eligible for COBRA
coverage under your medical plan because s/he is
outside of the 60 day window of eligibility. If an unexpected event
does occur that prevents the student from continuing on, you will
need to take immediate action to notify your medical plan provider
of this extraordinary event if you want to obtain COBRA coverage.
And, in case you are denied, be very sure to follow all appeal steps
outlined in the SPD (Service Plan Description) provided by AT&T.
(Go to
https://access1.sbc.com
for the SPD – Editor)
CASE
IN POINT:
We are bringing this to the attention of all members because
this is what happened to an AASBCR member where the member’s
dependent graduated in June; was expecting to go on to graduate law
school in September; but wasn’t accepted. The notification of this
EVENT came in a letter in September which was more than 60 days past
her
June
College
graduation. As a result, the Company (AT&T/SBC) didn’t elect to
cover the dependent under COBRA and, in fact, deemed that coverage
for this dependent stopped in June (rather than when the event
notification of loss of student status that occurred in September).
The result was that the dependent was without insurance from June
through September and, in fact, AT&T stated that the dependent was
not eligible for COBRA coverage under the member’s plan since the 60
day eligibility period has elapsed. The former employee initially
appealed this denial of coverage following step 1 of the appeals
process. When he was rejected, he received a letter stating that he
had 180 days to perform a final appeal. Unfortunately, the retiree
didn’t follow up on the second appeal, even though had he done so,
he may have won the appeal because of the extenuating circumstances
and uniqueness of the “event”.
What
you may want to do if you are denied COBRA or any other medical
coverage: Follow all steps of the appeal process. Remember,
not following the appeals process closely could cost you a bundle in
out of pocket non-covered medical expenses.
Disclaimer:
This is a public service notice provided by the AASBCR on behalf of
its members. It is not intended as an official interpretation of
the company (AT&T) sponsored COBRA plans outlined in the Company
Plan SPDs but merely is a heads up to what has been described to us
as a potential problem that may be encountered with COBRA and the
strict interpretation of the 60 day limit rule as administered by
the Company (AT&T) under the Department of Labor (DOL) issued
guidelines.
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