Getting HIPAA Certificate Of Creditable Coverage Like Pulling Tooth From Dragon's Maw

Sarek tells the story of how he was able finally get a “certificate of creditable coverage” from his COBRA administrators. After many moons of pleas, what it finally took was writing a physical letter to the presidents of each four companies at the same time. At the top of the letter was the address of each of the other companies so that all knew that he was showing off their unsightly bits to the other.

Sarek writes:

When my COBRA health insurance ran out early this year, I had to obtain an individual policy. In order to avoid any potential problems with the dreaded “pre-existing conditions,” I needed to submit the HIPAA Certificate of Creditable Coverage. This would show that I had been covered by a health insurance policy for the previous 12 months, therefore I could not be denied coverage for “pre-existing conditions.”

I found myself in a ping-pong game bouncing back and forth among my previous employer, my insurance carrier, the previous COBRA administrator, and the current COBRA administrator. Each pointed the finger at one of the others. “We’d love to help, but it’s the responsibility of [them].” I even had multiple conference calls with reps from all 4 companies, but no one would take responsibility. Supervisors were of no use.

I finally wrote a snail-mail letter to the presidents of all 4 corporations. I put the inside address of all 4 at the top of the letter so they could see I was exposing their tricks to all at the same time. I briefly summarized the problems I encountered. I casually dropped phrases such as “federally-mandated”, “U.S. law requires,” and “your business process is broken.” I told them the obvious conclusion was that it was “nobody’s job” to provide the form.

Within 2 weeks, I got a HIPAA form from each of the COBRA administrators, who had previously told me their contract didn’t allow it, or that they didn’t possess the required information.

My former employer and the insurer called to follow up that the others had sent me the form. While all 4 apologized for my inconvenience, nobody ever said that things would change going forward. So I wonder if others in my boat just gave up fighting the gray cloud?

Footnote: when I followed up with my new insurer, they said they’d lost the form that I had sent in, even though I had addressed it exactly how they told me to! I resent a copy and kept pestering them until they said it was in their system. Then I made them send me a confirmation so that I have it in writing.

Someday I’ll tell you how another insurance carrier lost my enrollment info so that I was effectively not insured until I noticed the problem.

Sometimes it takes a little sunshine to disinfect the stain of incompetence.