Dying Man Denied Health Coverage Over Missing 26 Cents
When Sergio Branco was diagnosed with acute myeloid leukemia earlier this year, his family knew the resulting medical expenses would rack up quickly.
Which is why, the Star-Ledger reports, the Edison resident and his wife Mara did everything they could to ensure that he was fully covered by a health insurance provider.
Unfortunately, after three months of leave to undergo chemotherapy, the 33-year-old truck driver was fired from his job at the waste management company Russell Reid.
Luckily, the Brancos had a fallback plan: Keep Sergio's health coverage going by signing up for coverage under the Consolidated Omnibus Reconciliation Act, or COBRA.
Employers pick up a big part of the tab for their workers’ health insurance premiums (that’s why it’s “employer-sponsored”). Under COBRA, however, terminated employees must cover the entire cost of their health insurance premium themselves — which means that health care becomes a significantly bigger expense for people after they lose their job. Workers receive written notification that they are eligible for COBRA coverage, and have 60 days after that point to decide whether they want to accept it.
With Sergio scheduled to undergo a $500,000 life-saving bone marrow transplant in mid-August, Mara knew it was critical to apply for COBRA coverage right away.
And so she did, sending a check for $518 to Paychex, Russel Reid's third-party benefits administrator.
Except that in her rush to maintain Sergio's health insurance, Mara inadvertently neglected to write down the full monthly premium amount on her check: $518 and 26 cents.
Neither she nor Sergio knew anything was amiss since Paychex happily cashed the couple's check, but a few weeks later Sergio was abruptly informed by the hospital that he was no longer covered.
Thinking it was just a matter of sending Paychex the missing 26 cents, Mara was shocked when a representative told her the company could not accept any additional payments from the Brancos per Russell Reid instructions.
Mara's next call was to Russell Reid’s human resources rep Rich Gross.
"The whole time he said Paychex is giving me false information," Mara told the Star-Ledger. "I told him if he’d just make a phone call everything would be alright. He said he’d see what he could do."
Gross did nothing, Mara said, and neither did the Department of Labor.
Even a letter from Sergio's doctor saying plainly that the young father would die without the transplant had no effect on the parties involved.
It wasn't until reporters and attorneys got involved that Paychex suddenly changed its tune.
Last week, just days before the transplant was set to take place, the Brancos got their health insurance back.
"The Department of Labor said the company will reinstate him from May till now," Mara is quoted as saying. ""They said the company did it wrong. I am super happy. It’s like a weight has lifted off my shoulder."
The Brancos have since decided not to pursue legal action.
