I Was Terminated In 2024 And Only Just Found Out I Was Still On My Old Employer's Health Plan The Whole Time Because Of Employer Mistake. Employer Now Says Retroactive Cancellation Even Though I Brought The Mistake To Their Attention.
Location: Virginia. Trying to figure out how much of a problem I actually have and whether this is worth a lawyer (if yes, what type of lawyer).
Timeline:
- Feb 2024 — laid off from a US subsidiary of a large multinational. I got emails at the time saying COBRA materials would be mailed to me. Nothing ever arrived.
- Assuming I had no coverage, I bought an individual marketplace plan and paid roughly $450/month out of pocket for it. Same carrier as my old group plan, coincidentally.
- ~29 months later — I switch to a new carrier and discover that I was still enrolled as an active employee on my former employer's group plan that entire time. Never terminated. Providers had been billing that plan.
- July 2026 — I email HR asking them to (a) terminate the enrollment, (b) show me the COBRA notice or confirm none was issued, and (c) furnish plan documents under ERISA §104(b)(4).
What they've told me since, in writing:
- HR: "We did report your correct termination date to the carrier — the error was on the carrier's end, and it's being corrected."
- HR: The COBRA administrator confirms a notice was mailed in March 2024 to my correct address. (First they said the 24th, then the 22nd.) They have not produced the notice or a mailing record. The COBRA admin says the only record it keeps is the date the qualifying event file came in from the employer's EDI vendor. That date has not been provided.
- HR later: the carrier initially terminated me effective June 2026 because it "could only go back 60 days for an initial retro termination," and a correction back to Feb 2024 is under internal review.
- HR: if the carrier does retro-terminate to Feb 2024, all claims paid since then will be reversed.
- HR, most recently: "We are now considering this matter closed." They have also never given me the plan administrator's name/address or the agent for service of process, despite three written requests.
And then the carrier told me, in writing:
So the carrier is saying it cannot terminate anyone on its own — it only acts on employer transmissions. Which seems hard to square with the employer's claim that the 29-month failure was the carrier's error. The "60 days for an initial retro termination" line also reads to me like a first-time submission, not a correction of something sent in 2024. But I might be reading too much into it.
Carrier says talk to the employer. Employer says the matter is closed.
My questions:
- The clawback is what scares me. If they push the Feb 2024 retro termination through, I'm looking at 2+ years of adjudicated claims reversed and providers billing me directly. Is that a prohibited rescission under ACA §2712 (no retroactive cancellation absent fraud or intentional misrepresentation), or does an "eligibility correction" get around that? Has anyone seen this fight actually play out?
- How much does the COBRA notice claim actually matter? I know the standard is "reasonably calculated to ensure actual receipt," not proof of receipt, and they say the address was right. But my coverage never ended, so there was no loss of coverage for COBRA to continue. Does that go anywhere, or is it a dead end?
- The §104(b)(4) piece — written request July 31, they acknowledged in writing that the administrator must furnish within 30 days "or face daily penalties," then declared the matter closed. That's the cleanest failure I have. Realistic?
- Damages. ~$450/month in duplicate premiums for coverage I didn't need is the concrete number. Anything else I'm not seeing?
- Practical: every plaintiff-side firm I've called has passed — I think because it screens as a small COBRA case. Is there a better way to frame the intake call, or a type of practice I should be targeting instead?
I've already filed with EBSA and put a written objection to retroactive termination on file with the carrier.
TL;DR: Employer never processed my 2024 termination, left me on the group plan 29 months, never got a COBRA notice, paid $450/mo for duplicate individual coverage the whole time. Now they want to retro-cancel back to 2024 and reverse every claim. Employer says matter closed, carrier says talk to employer. What's my exposure and what's my best claim?
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