I've lost my job. Now what?

The following information was discussed by Attorney Whitney Hughes on the February 27, 2009 edition of Legal Briefs on KDKA's Pittsburgh Today Live.

Unfortunately it’s a sign of the times. With the economic downturn, many companies are downsizing and through no fault of their own, many people are finding themselves out of work and with few options.

Below are some common questions and some tips on navigating through filing for unemployment compensation and continuing to receive health care benefits through COBRA.

After seven years with my company, it has decided to let me go. I know I need to file for unemployment compensation, but how do I get started?

Unemployment compensation protects workers against job loss by providing temporary income support to people who become unemployed through no fault of their own. Benefits are paid for a limited time to individuals who are able and available for suitable work and are actively seeking new employment. To qualify for benefits, a worker must have performed services covered under the Pennsylvania Unemployment Compensation Law, and must have worked for an employer who is required by law or elects to pay into the Unemployment Compensation Fund.

To file for unemployment benefits, you will need to fill out an application online at www.dli.state.pa.us, or you can call one of the unemployment compensation call centers.

After filing an initial application, you can expect to receive by mail a financial determination, PIN, and date to file your bi-weekly claim for benefit weeks by Internet or over the phone. If you filed online, you will receive an e-mail confirmation of your application.

In order to receive UC benefits, you must file for your unpaid waiting week and your biweekly claims for benefit weeks in which you are unemployed. Claims can be filed over the Internet or over the phone. Usually, you will file claims for two weeks at a time; that is, you will file over the Internet or call every two weeks. You will be given a date to file your biweekly claim for the first time.

How do I know whether or not I’m eligible to collect unemployment?

After filing an application for UC benefits, there are three basic steps to determining eligibility for unemployment compensation.

  1. Financial eligibility - The first step is determining whether you are eligible financially. In other words, did you earn sufficient wages from an employer covered by the PA Unemployment Compensation Law? Certain types of employment are exempt. Generally speaking, all employers providing full and/or part-time employment to one or more workers must be registered with the Office of Unemployment Compensation Tax Services.

  2. Benefit eligibility - If your wages make you financially eligible, the second step involves the nature of your job loss or separation. In other words, are you out of work through no fault of your own? This decision is based on the information you supply when you file for benefits and information collected from your former employer.

  3. Maintaining eligibility and requalifying for benefits - The third qualifier to receiving unemployment benefits involves meeting various tests on a week-to-week basis. For example, you must be able and available to accept suitable work, not refuse work when offered without good cause, and participate in reemployment services if required.

I was receiving unemployment compensation benefits and now received a notice that says I have been overpaid. Do I have to pay this all back and does it have to be paid all at once?

Benefits you received to which you were not entitled are known as overpayments. Depending on the situation, these overpayments are divided into two groups: those which are your fault and those which are not.

If you believe that a benefit payment was issued to you improperly or in the wrong amount, you must contact the unemployment compensation office immediately.

A "fault overpayment" can result if you withhold or misrepresent material facts. A fault overpayment can result if you accept and cash a benefit check which you know or should know you are not entitled to receive.

You must repay a fault overpayment. The entire overpaid amount is due at the time the Notice of Overpayment is issued. The department does accept installment payments.

However, you will be required to pay interest on any fault overpayment principal not paid within 15 days after the Notice of Overpayment is issued.

A "non-fault recoupable” overpayment results when it is determined that the overpayment was through no fault of your own, or you did not misrepresent or withhold facts. A non-fault overpayment will be deducted from future benefit payments during that benefit year and the three-year period immediately following that benefit year. The deductions may not exceed one-third of the weekly benefit rate. However, if the total overpayment is $99 or less, it will be deducted in full.

A "non-fault nonrecoupable" overpayment results when the overpayment is not due to misrepresentation or non-disclosure of a material fact, and is caused by reason of:

  • a subsequent reversal of two decisions of eligibility;
  • the subsequent receipt of holiday, vacation, or other pay of which you had no knowledge; or
  • a subsequent determination that your base-year wages were not earned in employment as defined by the Pennsylvania Unemployment Compensation Law.

You are not required to repay a “non-fault nonrecoupable” overpayment.

It’s bad enough that I’ve lost my job. Am I losing my health insurance too?

Most likely you will be eligible for COBRA benefits.

The law generally covers health plans maintained by private-sector employers with 20 or more employees, employee organizations, or state or local governments.

COBRA provides certain former employees, retirees, spouses, former spouses, and dependent children the right to temporary continuation of health coverage at group rates. This coverage, however, is only available when coverage is lost due to certain specific events. Group health coverage for COBRA participants is usually more expensive than health coverage for active employees, since usually the employer pays a part of the premium for active employees while COBRA participants generally pay the entire premium themselves. It is ordinarily less expensive, however, than individual health coverage.

To be eligible for COBRA coverage, you must have been enrolled in your employer's health plan when you worked and the health plan must continue to be in effect for active employees. COBRA continuation coverage is available upon the occurrence of a qualifying event that would, except for the COBRA continuation coverage, cause an individual to lose his/her healthcare coverage.

There are three elements to qualifying for COBRA benefits. COBRA establishes specific criteria for plans, qualified beneficiaries, and qualifying events:

Plan coverage - Group health plans for employers with 20 or more employees on more than 50 percent of its typical business days in the previous calendar year are subject to COBRA. Both full and part-time employees are counted to determine whether a plan is subject to COBRA.

Qualified beneficiaries - A qualified beneficiary generally is an individual covered by a group health plan on the day before a qualifying event who is either an employee, the employee's spouse, or an employee's dependent child. In certain cases, a retired employee, the retired employee's spouse, and the retired employee's dependent children may be qualified beneficiaries. In addition, any child born to or placed for adoption with a covered employee during the period of COBRA coverage is considered a qualified beneficiary. Agents, independent contractors, and directors who participate in the group health plan may also be qualified beneficiaries.

Qualifying events - Qualifying events are certain events that would cause an individual to lose health coverage. The type of qualifying event will determine who the qualified beneficiaries are and the amount of time that a plan must offer the health coverage to them under COBRA. A plan, at its discretion, may provide longer periods of continuation coverage.

Qualifying events for employees:

  • Voluntary or involuntary termination of employment for reasons other than gross misconduct
  • Reduction in the number of hours of employment

Qualifying events for spouses:

  • Voluntary or involuntary termination of the covered employee's employment for any reason other than gross misconduct
  • Reduction in the hours worked by the covered employee
  • Covered employee's becoming entitled to Medicare
  • Divorce or legal separation of the covered employee
  • Death of the covered employee

Qualifying Events for Dependent Children:

  • Loss of dependent child status under the plan rules
  • Voluntary or involuntary termination of the covered employee's employment for any reason other than gross misconduct
  • Reduction in the hours worked by the covered employee
  • Covered employee's becoming entitled to Medicare
  • Divorce or legal separation of the covered employee
  • Death of the covered employee

How long do I have to decide whether or not I want the COBRA coverage?

If you are a qualified beneficiary, you must be given at least 60 days for the election. This period is measured from the later of the coverage loss date or the date the COBRA election notice is provided by your employer or plan administrator. The election notice must be provided in person or by first class mail within 14 days after the plan administrator receives notice that a qualifying event has occurred.

As always, for any questions regarding foreclosures, you may contact the Allegheny County Bar Association’s Lawyer Referral Service at 412-261-5555.