~ COBRA ~
COBRA is not the insurance, it is the 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.
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.)
You will usually pay the entire premium, including any portion the employer has been paying, plus a 2% administrative charge.
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.
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:
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.
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 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 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.
For COBRA appeals information or notification rights, you may contact:
U.S. Department of Labor