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Wife is getting hip surgery company selling location

Discussion in 'Health Insurance, HMO, HIPAA & Disability' started by joe28snj, Nov 28, 2006.

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  1. joe28snj

    joe28snj Law Topic Starter New Member

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    My wife and I both work for the same company we manage a self storage property in south Jersey. She is young 29 but is scheduled for surgery on friday. Our property is for sale ... the vice president says there is a contract on the property and it could be transferred to the next owner by Jan 9th. Since she is going to be on disability as of the day after surgery. At least paperwork will be submitted. Does her normal health coverage oxford continue until after she is cleared to go back to work after the recovery period.

    We are really concerned that even though surgery and rehab for the first two weeks will be covered will she still have medical coverage for physical therapy. We don't need medical expenses to be too high especially since the company we are at is our apartment and both of our jobs.

    Any advice or information would be very helpfull ... Thank you

  2. cbg

    cbg Super Moderator

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    I think I explained this to you once before. The answer has not changed.

    Her employer is NOT required to continue her insurance through the disability period. He just isn't, no matter how much you want that to be the answer.

    IF she qualifies for FMLA, then the employer must continue the insurance at the same rate as if she were working (i.e. if an active employee pays 20% of the cost, the employee on FMLA also pays 20% of the cost) until the FMLA expires. However, if FMLA does not apply, or after FMLA expires (12 weeks maximum) then her employer has no legal obligation to continue her insurance regardless of her disability status.

    If the company is sold, the terms of sale will determine what benefits continue and what do not. The terms of sale will also determine what, if any, benefits offered by the new owner will apply. That's just something I can't address.

    Under no circumstances is she entitled by law to have the employer continue insurance benefits longer than 12 weeks, and only then if FMLA applies.

    However, if the company has more than 20 employees, (or possibly less depending on what state you are in) the employer does have to offer COBRA. COBRA would mean she could continue on the same insurance AT HER EXPENSE. She would have to pay the entire cost; both the portion that she generally pays, plus a 2% administration fee.

    If you can answer the following questions;
    1.) What state you are in
    2.) How many employees (1) overall (2) within 75 miles of your location
    3.) How long your wife has worked for this employer
    4.) Whether she worked full time or part time

    I can give you slightly more specific information.

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