Stan Rosen of Miramar lost his job, his wife was six months pregnant and he faced an operation — but he felt he could manage because he had COBRA health insurance.

Then, he mistakenly underpaid his November bill by two cents, and his benefits administrator said his policy was being canceled. Rosen and his wife, Sabrina, saw their life crumbling. He quickly paid the two cents, but it was only after he and his dad called about 100 times and The Miami Herald inquired that the company relented and continued coverage.

The Rosens' case is an extreme example of something that's happening frequently throughout South Florida: Laid-off workers are struggling through a difficult maze to keep health insurance while insurers and former employers have no interest in helping them beyond what federal and state laws require.

"COBRA has numerous limitations," says Ron Pollack, head of Families USA, a Washington health care consumer advocacy group. "It is a very important right that's not meaningful in reality."

Rosen agrees. "It sure looks like they were trying to screw people over on purpose," he said about the missing two cents. Before he and his wife learned the policy had been reinstated, they debated whether she should keep an appointment with a specialist that could cost them thousands of dollars without insurance. "She was kind of flipping out."

Federal COBRA continuation coverage requires companies with more than 20 employees to offer laid-off workers up to 18 months of health insurance in most cases, as long as the worker pays the entire cost of the premium.

In South Florida, COBRA can easily cost $1,200 a month for a family, and many find that too expensive. The Obama administration last year began subsidizing 65 percent of COBRA costs for up to nine months, but many still can't afford it.

Companies with fewer than 20 employees are covered by a state law, but people who have had to use it, like Robert Dollar of South Dade, say it's even more convoluted than the federal law.

"My COBRA has turned into a hysterical joke," says Dollar, who paid $712.34 a month just to cover his wife. "Basically you're lost in the cracks."

Federal law requires large companies to give departing employees a thick COBRA packet stuffed with explanations. But state law makes no such demand on small companies, like the one Dollar worked for.

Dollar made dozens of phone calls and sent faxes to the company's insurer, Neighborhood Health, to get the continuation coverage, and then his former company switched to Aetna. Dollar had to go through the whole process again. "It's a maze of stuff," he said.

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