What is COBRA?
COBRA is not the insurance, it is U.S.A. law, since 1985 - the Consolidated Omnibus Budget Reconciliation Act.
COBRA allows for the temporary continuation of employer group health insurance for employees and their dependents, when that insurance would otherwise end.
Insurance plans under COBRA are private health plans, not sold by the government.
The U.S. Departments of Labor and Treasury have jurisdiction over private sector health plans and enforcement of COBRA; the IRS, under the U.S. Department of Treasury, publishes regulations of COBRA provisions, eligibility and premiums.
How do I sign up for COBRA?
You and any of your dependent beneficiaries must be offered the same health insurance benefits, with the same deductibles and benefit limits, you were receiving before you qualified for COBRA (before a qualifying event).
You must sign up within 60 days or lose the right to coverage. To sign up, talk to your employer's benefits division. Companies usually send forms to sign up for COBRA within 30 days after your group health insurance has ended. (Forms may never mention the word COBRA, just the opportunity to continue group health insurance coverage.)
What Does COBRA Cost?
You will usually pay the entire premium, including any portion the employer has been paying, plus a 2% administrative charge.
Who is Eligible for COBRA?
Plan coverage - you must be in the employer group health plan and the plan must have over 20 employees.
You must have worked at least 50% of the working days in the previous calendar year.
Beneficiary coverage - you (employee, spouse, and/or dependent child) must be covered by the group health plan on the day before the "qualifying event".
Qualifying events - a specific event happens that causes you to lose employer group health care coverage.
What Events Qualify Me for COBRA Benefits?
Specific events determine who is a qualified beneficiary and how much time and employer group health plan must offer the continuation of health coverage under COBRA. (Again, a qualified beneficiary could be an employee, a spouse, and/or a dependent child.)
5 types of events to qualify for COBRA benefits:
- Death of the covered employee
- Voluntary or involuntary termination/reduction of employment hours (other than for "gross misconduct")
- Divorce/legal separation from the covered employee
- Covered employee becomes entitled to Medicare (COBRA only for spouse or dependent child of covered employee)
- Loss of "dependent child" status under the group health insurance plan rules
NOTE: A second qualifying event during the initial period of coverage, may extend coverage to a total of 36 months under COBRA. If you or a covered dependent's status changes after they are under COBRA (marital, dependent, or disability status), you should contact the plan's administrator UB, to see if their COBRA coverage will be extended.
What if I am Disabled?
If you qualify for SS disability benefits, special rules apply to extend the 18 months of coverage an additional 11 months - to a total of 29 months.
Once a disability determination is made, you must give notice to the Plan Administrator (in the former employer's benefits division) within 60 days of receiving the determination (this increases the period of coverage to 29 months).
After the normal period of coverage (18 months) is completed, the premium may increase to 150% of plan's total cost of coverage, for the last 11 months of COBRA coverage for disables beneficiaries.
How Long am I Covered by COBRA?
How long the employer group health plan must offer continuation of coverage depends on the type of qualifying event. COBRA specifies the maximum required periods of time that continued group health coverage must be offered to qualified beneficiaries. However, a plan may provide a longer period of coverage beyond those required by COBRA.
When Does COBRA Coverage End?
When on of these situations happen, COBRA coverage will usually end:
- Maximum period of coverage is reached (18, 29, or 36 months)
Premiums are not paid on time
- Employer stops offering a group health plan or goes out of business
Beneficiary gets full or equivalent coverage with another employer group health plan
- If beneficiary becomes entitled to Medicare (even if they don't enroll, they are not eligible for COBRA)
For further information about COBRA, read your employer's group health plan booklet or call your employer group health insurance plan administrator, or visit the web site here:
For COBRA appeals information or notification rights, you may contact:
U.S. Department of Labor
Pension and Welfare Benefits Administration
Division of Technical Assistance and Inquiries
200 Constitution Ave., NW (Room N-5658)
Washington, D.C. 20210
(202) 219-8784 or (202) 219-8776