Our Health Law Unit seeks pro bono assistance on behalf of our client who wishes to pursue affirmative litigation against her prior employer who failed to properly notice a COBRA-qualifying event and retroactively disenrolled our client from their health insurance. These actions caused our client to be ineligible for Medicaid and left her with extensive medical debt. 

Our client worked for a New York State-run psychiatric program until October 2020 when she was terminated due to loss of funding during the onset of the COVID-19 pandemic. Our client had a self-funded health insurance plan through her job and coverage was set to end a month after her termination. Our client was approved for Medicaid once she believed her employer-provided health insurance ended. However, the New York State of Health (NYSOH) sent her notice that she could not enroll into a Medicaid managed care plan because she was still enrolled in her prior plan. Our client did, however, qualify for Medicaid fee-for-service as secondary insurance. When our client attempted to disenroll from the employer-provided plan she was told that her employer would have to terminate her coverage and that she could not do so unilaterally. Our client made numerous attempts to contact her former employer’s HR department but never received a call back. Our client needed medical attention during this time, so she continued to use her employer-provided insurance with Medicaid fee-for-service. Between 2020 and 2022, our client went a step further and confirmed her coverage by calling plan provided by her previous employer before most, if not all her doctor visits.  

In January 2023, our client called her plan before a medical appointment and was told that her former employer terminated her coverage retroactively to November 2020. Our client received a COBRA notice dated 2023 indicating that in 2020 she experienced a COBRA-qualifying event and that she would have to pay over $800/month retroactively to 2020 to receive coverage. Our client cannot afford to pay retroactively for COBRA because most, if not all, of the medical providers she saw between 2020-2022 do not accept Medicaid fee-for-service. Our client is now responsible for all doctors’ fees billed during her non-coverage period, which she cannot afford. 

Initial research by our Health Law Unit on the COBRA FAQ on the NYS Department of Financial Services website indicates that employers are supposed to send COBRA notification within 30 days of the qualifying event. Furthermore, our client was supposed to receive a COBRA letter 30 days after her job loss and not three years after the fact.  

Our Health Law Unit advocates seek pro bono co-counsel to explore what steps our client should take to address the failure of her prior employer and represent our client on the relevant advocacy and potential litigation.