It appears that the question “Can anyone spare a quarter?” is not one you need to be worried about when your life is on the line. But one couple found out exactly how dire of a situation a little more than a quarter could get them into after the husband’s health coverage was terminated months before he was scheduled for a bone marrow transplant to treat his leukemia. The reason? A $0.26 shortfall on a monthly COBRA premium.
Karin Price Mueller of the New Jersey Star-Ledger spoke to the man’s wife, who inadvertently wrote a check for $518.00 instead of $518.26 when sending payment to Paychex, the company handling COBRA for her husband’s previous employer.
It was all a mistake, says the wife, one that almost cost her husband his life. Paychex cashed the check at first, and the man kept on receiving treatment. Then the hospital told him he didn’t have insurance coverage.
The wife contacted Paychex and says she was told for the first time that the payment had been off by $0.26. There was no option to bring the payment up-to-date either, she said. The couple had even paid the premium (besides that quarter) well before it was due. Paychex reportedly told her that her husband’s previous employer had instructed it not to accept any more payments.
The employer, meanwhile, claimed it was all a mix-up and that it was all Paychex’s fault.
“The whole time he said Paychex is giving me false information,” the wife said of her conversation with a human resources rep at the company. “I told him if he’d just make a phone call everything would be alright. He said he’d see what he could do.”
But still, nothing happened, she says, with the transplant date of Aug. 16 looming.
Even the man’s doctor tried to help, telling both the former employer and Paychex that the man “will most certainly die in the very near future if he does not proceed to transplant; therefore I am writing to request that every effort be made to reinstate his health care insurance coverage.”
Nothing was resolved until the family’s lawyer got involved, and filed a motion on their behalf last week. His argument — that the law states the man must have been notified of the delinquent $0.26 before coverage was terminated, and given a chance to pay. The law also says coverage can’t be terminated for “non-payment of a de minimis amount.”
After the Department of Labor got involved as well, it appears that Paychex is willing to work with the family.
“Paychex is working diligently with our client and other appropriate parties right now to reinstate [the man's] coverage,” a spokeswoman said.
If that isn’t clear enough, there’s this good news: “The Department of Labor said the company will reinstate him from May till now,” the wife said after much wrangling last week. “They said the company did it wrong. I am super happy. It’s like a weight has lifted off my shoulder. It’s better than winning the lottery.”
Bamboozled: Life-saving transplant denied, health insurance canceled over 26-cent shortfall [New Jersey Star-Ledger]