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Conexis / conexis pulling a fast one

1 Sonoma County, CA, United States Review updated:

I am in the last month of the federal COBRA coverage being managed by Conexis. They have arbitrarily changed my premium rate based on information provided in error by my former employer, who has recognized the error and has tried to change the mistake. Instead, Conexis is charging my former employee an extra $500 and trying to state that I owe $300 from September 2010 which they acknowledged they didn't bill me for. Now, two days before Christmas, they are demanding by "word of mouth" and "email" that I pay this extra $300 without an explanation for the change. They have floated a couple of random numbers without explanation. If I don't pay, they will cancel the remaining 10 days I have left, thereby threatening the Cal-Cobra I am now eligible for.

I thought Conexis was indulging in unfair business practices when this first uneasy relationship began in August/September of 2009. They informed me I had no coverage going back at least 45 days and demanded I pay 2-3 months "back premiums" to show that I had had continuous coverage without actually having the benefits available. They said that they didn't benefit anything, that was just the way the system worked. Now, they are utilizing strong arm tactics at the last minute demanding I pay an extra $300, without question or adequate notice, or they will cut off my benefits and threaten my continuing benefits with Cal-Cobra.

Where is California's insurance commissioner and why isn't he investigating Conexis for unfair business practices against California's struggling unemployed?

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  • Do
      30th of Dec, 2010
    0 Votes

    First of all, a thid party administrator (TPA) like CONEXIS can only work with the premium information provide by your former employer. You stated that the gave CONEXIS the wrong information, right? How is your former employer attempting to correct this with CONEXIS? Once they correct it with the TPA, there should be no issue. Sounds like your former employer may be giving you the run around??? If not, have them call CONEXIS with youto straighten it out.
    Secondly, COBRA continuation coverage is just that, a continuation or continuous with no gaps in coverage. The time period from when you lose coverage with your former employer until you elect COBRA does usually result in inactive coverage, but as soon as you elect to continue your coverage it will retro back to the day you lost it. You do need to pay for your coverage during this time even though it may have been inactive. So again, once you pay your coverage is active with no gaps. You maynot have been able to use it at the time, but if you had any eligible out of pocket expenses duringthat time you can submit the claims to your insurance carrier for reimbursement.
    Based on this, it sounds like CONEXIS is being compliant with COBRA law and doing what they are contracted to do... be the Third Party Administrator for you COBRA.

    Hope this helped. Here is a link to Department of Labor publication regarding COBRA. You should be able to find many answers in there.

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