If your employer cancelled your health insurance without notice, the first thing to understand is that federal law usually does not require advance warning that coverage will end. What it requires is a COBRA election notice giving you the right to continue that coverage after it stops, and you generally have at least 60 days from that notice to decide. In the meantime, losing job-based insurance opens a Special Enrollment Period on the Health Insurance Marketplace, and if the required notices never arrived, you have grounds to file a complaint and, in some cases, sue.
What Notice Your Employer Actually Owed You
COBRA generally applies to health plans at employers that had 20 or more employees on a typical business day the previous year.1Office of the Law Revision Counsel. 29 U.S.C. § 11612Office of the Law Revision Counsel. 29 U.S.C. § 11663Department of Labor. FAQs on ACA Implementation Part 19
ERISA adds a separate disclosure duty. If your employer significantly reduces benefits, the plan generally must send a summary of the change within 60 days after it is adopted.4Department of Labor. Reporting and Disclosure Guide for Employee Benefit Plans So while silence before the cancellation may not violate the law on its own, silence afterward often does.
How To Get Covered Again Right Now
You usually have more than one path back to coverage. COBRA lets you keep the plan you already had, typically for 18 months and up to 36 months for certain qualifying events. You will generally pay the full premium plus a 2% administrative fee.5Office of the Law Revision Counsel. 29 U.S.C. § 1162
Losing job-based coverage also triggers a Special Enrollment Period on the Health Insurance Marketplace, which gives you about 60 days to pick a plan outside the usual open enrollment window. Depending on your income, you may qualify for subsidies that lower the monthly premium.6HealthCare.gov. If you lose job-based health insurance
Other routes worth checking:7HealthCare.gov. Special Enrollment Period
- Medicaid, if your income qualifies
- The Children’s Health Insurance Program (CHIP) for kids in the household
- Enrolling as a dependent on a spouse’s employer plan
When The Cancellation May Have Been Illegal
A few situations turn a botched cancellation into an actual violation. If the person or entity managing your plan mishandled plan money or otherwise breached fiduciary duties, ERISA holds them liable.8Department of Labor. Fiduciary Responsibilities9Office of the Law Revision Counsel. 29 U.S.C. § 1132 Skipping the legally required COBRA or ERISA notices is itself a violation.
Federal law also prohibits pulling benefits based on protected characteristics, including:10Equal Employment Opportunity Commission. Compliance Manual Section 3: Employee Benefits
- Race
- Gender
- Disability
- Age
- Religion
How To Report It And What You Can Recover
For private-sector plans, complaints go to the Department of Labor’s Employee Benefits Security Administration (EBSA), which handles COBRA and ERISA issues.11Department of Labor. About EBSA Keep copies of every email, letter, pay stub, and notice from your employer and the plan; the paper trail is what a complaint or lawsuit runs on.
Under ERISA, you can bring a civil suit to recover benefits you were owed, enforce your rights under the plan, or clarify future benefits, and courts may award attorney’s fees. When an employer fails to provide required COBRA notices, a court has discretion to order a penalty of up to $100 per day for each affected person.9Office of the Law Revision Counsel. 29 U.S.C. § 1132
If you believe your benefits were cut because of a protected characteristic, file a charge with the Equal Employment Opportunity Commission. Depending on the law involved, remedies can include reinstating benefits, back pay, and money damages.10Equal Employment Opportunity Commission. Compliance Manual Section 3: Employee Benefits12Equal Employment Opportunity Commission. Remedies For Employment Discrimination
The IRS enforces the ACA’s tax penalties against large employers that fail to offer affordable coverage, but for plan management and notice problems, EBSA is the right door.13Internal Revenue Service. Employer Shared Responsibility Provisions