the post-September 3, 1991 medical expenses of Edith Boudas ("Mrs. Boudas") under the Employee Retirement Income Security Act ("ERISA"), 29 U.S.C. § 1001, et seq., or alternatively, that if liable, it is entitled to indemnity or contribution from defendants Benda Travel, Inc. ("Benda") or American Selfcare corporation ("ASC").
Mrs. Boudas was an employee of Easy Travel Services, Inc. ("Easy Travel"), which maintained an employee welfare benefit plan (the "Plan") pursuant to ERISA. Insurance coverage under the Plan was provided by Prudential's Group Policy No. 84879. Effective December 28, 1988, Mrs. Boudas became insured as an employee of Easy Travel and as a participant under the Plan. Mrs. Boudas' employment terminated February 3, 1990, and pursuant to § 602(2)(A)(i) of ERISA, she elected continuation coverage under the plan. Mrs. Boudas' continuation coverage was to continue for eighteen months, until August 3, 1991. 29 U.S.C. § 1162(2)(A)(i).
On April 28, 1991, the Social Security Administration issued a Retirement, Survivors and Disability Notice of Award to Mrs. Boudas, notifying her that as of February 2, 1991, she was entitled to Social Security Disability benefits. Specifically, the Notice of Award stated: "We have determined that you became disabled on February 2, 1991." Easy Travel, through ASC, the company responsible for administering Mrs. Boudas' continuation coverage, notified Mrs. Boudas that she was eligible for an additional eleven-month extension of her participation in the Plan; Mrs. Boudas was informed that this extension was because "of the fact that [she] was disabled at the time of [her] original Qualifying Event Date." Consequently, on June 10, 1991, Mrs. Boudas sent a letter to Benda
requesting that her coverage be continued for twenty-nine months (eighteen plus an additional eleven), rather than the original eighteen month continuation.
Sections 601-08 of ERISA contain provisions allowing continuation of health care coverage after the coverage would otherwise terminate. Section 602(2)(A) provides that in the event of a qualifying event, such as the termination of employment, continuation coverage will extend eighteen months from the date of such qualifying event. See 29 U.S.C. § 1163(2) (definitions of qualifying event). A recent amendment to § 602(2)(A), however, provides for an additional eleven months of continuation coverage for an individual determined under the Social Security Act to have been disabled at the time of the termination of employment. Specifically, the amendment provides:
In the case of an individual who is determined, under title II of XIV of the Social Security Act [ 42 U.S.C. § 401 et seq. or § 1381 et seq.], to have been disabled at the time of a qualifying event described in section 1163(2) of this title, any reference in clause (i) . . . to eighteen months with respect to such event is deemed a reference to 29 months. . . .