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how long are cobra benefits

by Dr. Kitty Franecki II Published 3 years ago Updated 2 years ago
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Under the Consolidated Omnibus Budget Reconciliation Act (COBRA) , continuation of health coverage starts from the date the covered employee's health insurance ends and, depending on the type of qualifying event, may last for 18 months, 29 months or 36 months.May 6, 2021

How long do employers have to provide Cobra in?

Within 14 days of that notification, the plan administrator is required to notify the individual of his or her COBRA rights. If the employer also is the plan administrator and issues COBRA notices directly, the employer has the entire 44-day period in which to issue a COBRA election notice.

Who is not eligible for Cobra?

  • Death of Covered Employee
  • Gets divorced or Legal Separation
  • Loses coverage because the covered employee qualifies for Medicare
  • Loses coverage because the covered employee is terminated
  • Dependent Child ceasing to be a Dependent

How many months of Cobra can I get?

People who are disabled under Title II or Title XVI of the Social Security Act and who are eligible for federal COBRA are eligible for up to 29 months of federal COBRA coverage, plus up to an additional 7 months of state continuation coverage, for a total of up to 36 months.

How long can I Keep my Cobra coverage?

The length of time you can keep COBRA coverage depends on your qualifying event (see the next section). If your major medical coverage ends because your employment ends (other than for gross misconduct), or because your hours are reduced, you and your qualified dependents can keep coverage under the employer’s health insurance for up to 18 months by paying for the full cost of the coverage.

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How long can you stay on COBRA after leaving a job?

18 monthsYou can keep your job-based insurance policy through the federal Consolidated Omnibus Budget Reconciliation Act, or COBRA. COBRA allows you to continue coverage — typically for up to 18 months — after you leave your employer.

Can COBRA last longer than 18 months?

COBRA requires that continuation coverage extend from the date of the qualifying event for a limited period of 18 or 36 months. The length of time depends on the type of qualifying event that gave rise to Page 6 6 the COBRA rights.

How long does COBRA usually last?

Specific Qualifying EventsQualifying EventLength of CoverageInvoluntary Termination of Employment (getting fired from job)18 MonthsDivorce, Annulment, Termination of Domestic Partnership, or Legal Separation36 MonthsChild ceases to be a Dependent (e.g. child turns 26)36 MonthsDeath of Employee36 Months2 more rows

Can COBRA Be Extended?

Consumers may also extend COBRA continuation coverage longer than the initial 18-month period with a second qualifying event —e.g., divorce or death— up to an additional 18 months, for a total of 36 months.

Is COBRA extended because of Covid?

Soon after the COVID-19 pandemic shut down the nation, the federal government extended the deadlines for electing COBRA and paying COBRA premiums for continuation of health insurance coverage.

What happens when COBRA runs out?

When your COBRA health insurance runs out, you can be eligible for a Special Enrollment Period that will allow you to enroll in an Obamacare health plan. Qualify for a Special Enrollment Period? Then you have 60 days from the end of your COBRA coverage to enroll in a plan from the Marketplace.

Can I get COBRA if I quit my job?

Electing COBRA means you can keep your health insurance after quitting or being fired from a job. You are responsible for paying your premium and the employer's premium, plus a 2% admin fee. Coverage is available for up to 18 months, but an extension may be possible.

How do COBRA benefits work?

COBRA is a federal law about health insurance. If you lose or leave your job, COBRA lets you keep your existing employer-based coverage for at least the next 18 months. Your existing healthcare plan will now cost you more. Under COBRA, you pay the whole premium — including the share your former employer used to pay.

How does COBRA work if I get a new job?

You may stay on COBRA as long as you do not obtain other insurance or become covered under your new employer's health insurance. The federal government's COBRA law allows workers to continue on the same plan they had when they working.

Is COBRA expiration a qualifying event?

Is your COBRA coverage about to expire? After months of not worrying about health insurance, do you know what to do next? Here's the good news: Rolling off of COBRA coverage is a qualifying event that opens a special enrollment period for you to purchase your own health coverage.

Are COBRA plans expensive?

On Average, The Monthly COBRA Premium Cost Is $400 – 700 Per Person. Continuing on an employer's major medical health plan with COBRA is expensive. You are now responsible for the entire insurance premium, whereas your previous employer subsidized a portion of that as a work benefit.

Can I cancel COBRA and get a refund?

Generally, there are no refunds. You may contact your administrator or your past employer for specific insurance payment information.

How long is Cobra coverage good for?

Employees are eligible for 18 months of continued coverage under COBRA if the qualifying event stems from reduction of hours or termination of employment for reasons other than gross misconduct. Note that termination can be voluntary or involuntary, including retirement.

How Long Does COBRA Last?

COBRA continuation coverage allows an employee to stay on their employer’s group health plan after leaving their job.

What is the second qualifying event for Cobra?

Instead, it must be due to the death of the covered employee, divorce or legal separation between the employee and his or her spouse, loss of dependent-child status under the plan rules or the covered employee qualifying for Medicare. Note that if a disabled beneficiary is receiving COBRA coverage for any of these reasons, the maximum coverage period is still 36 months.

Why is Cobra the most commonly outsourced human resource function?

COBRA is the most commonly outsourced Human Resources function because it is extremely complex and time-consuming when administered correctly. At BASIC, we have excelled at reducing risk and liability for employers since 1995 and have developed industry-leading best practices for COBRA administration to ensure consistent and reliable compliance that meets all the COBRA requirements.

What is a mini Cobra?

A number of states have “mini COBRA” laws that address coverage duration. While some states adhere to the federal guidelines mentioned in this article, other states have their own coverage periods that vary from federal law.

When will COBRA be available in 2021?

The COBRA subsidy is equal to 100% of COBRA premiums for eligible coverage and is available from April 1 , ...

Can you terminate Cobra coverage?

You can terminate a participant’s COBRA coverage prior to the duration set by law in the following cases:

How long do you have to continue Cobra?

When group coverage is lost due to termination or a reduction in hours, qualified beneficiaries must be provided with 18 months of continuation coverage from the date of the qualifying event. This is the most common and well understood COBRA coverage period.

How long does it take for a spouse to get Cobra?

If the covered employee became entitled to Medicare less than 18 months before the qualifying event (aka termination), COBRA coverage for the employee’s spouse and dependents is adjusted based on the date the employee became eligible for Medicare.

How long is a dependent eligible for medicaid?

In each of the above scenarios, the spouse or dependent is eligible for up to 36-months of coverage.

When does Joe retire from Medicare?

Joe was entitled to Medicare in January 2019, but continues on his employer’s health plan. He retires June 1, 2019. He enrolls in Medicare, but his wife, Jane, intends to continue the benefit. His wife would be eligible for 31 months (36 months less 5 months past since Joe was entitled to Medicare.)

Does Cobra extend beyond the federal period?

States may require that the COBRA coverage period is extended beyond the Federal coverage periods . States may also require “mini-COBRA” plans which affect employers with less than 20 employees as required by Federal COBRA.

Does Cobra cover a longer period?

Employers are entitled to offer a longer COBRA coverage period than required by Federal or State laws. It must be consistently applied for all qualified beneficiaries.

How long is Cobra coverage?

In certain circumstances, if a disabled individual and non-disabled family members are qualified beneficiaries, they are eligible for up to an 11-month extension of COBRA continuation coverage, for a total of 29 months. The criteria for this 11-month disability extension is a complex area of COBRA law. We provide general information below, but if you have any questions regarding your disability and public sector COBRA, we encourage you to email us at [email protected].

What is the cobra?

The Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA) amended the Public Health Service Act, the Internal Revenue Code and the Employee Retirement Income Security Act (ERISA) to require employers with 20 or more employees to provide temporary continuation of group health coverage in certain situations where it would otherwise be terminated.

What is a Cobra notice?

A notice of COBRA rights generally includes the following information: A written explanation of the procedures for electing COBRA, The date by which the election must be made, How to notify the plan administrator of the election, The date COBRA coverage will begin, The maximum period of continuation coverage, The monthly premium amount,

How long does it take to get a Cobra notice?

Separate requirements apply to the employer and the group health plan administrator. An employer that is subject to COBRA requirements is required to notify its group health plan administrator within 30 days after an employee’s employment is terminated, or employment hours are reduced. Within 14 days of that notification, the plan administrator is required to notify the individual of his or her COBRA rights. If the employer also is the plan administrator and issues COBRA notices directly, the employer has the entire 44-day period in which to issue a COBRA election notice.

How long do you have to notify Cobra?

Qualified beneficiaries must be given an election period of at least 60 days during which each qualified beneficiary may choose whether to elect COBRA coverage.

What is the COBRA requirement?

Title XXII of the Public Health Service (PHS) Act, 42 U.S.C. §§ 300bb-1 through 300bb-8, applies COBRA requirements to group health plans that are sponsored by state or local government employers. It is sometimes referred to as “public sector” COBRA to distinguish it from the ERISA and Internal Revenue Code requirements ...

How long does an employer have to issue a Cobra election notice?

If the employer also is the plan administrator and issues COBRA notices directly, the employer has the entire 44-day period in which to issue a COBRA election notice.

What is Cobra coverage?

This section provides information about COBRA continuation coverage requirements that apply to state and local government employers that maintain group health plan coverage for their employees. Group health plan coverage for state and local government employees is sometimes referred to as “public sector” COBRA to distinguish it from the requirements that apply to private employers. The landmark COBRA continuation coverage provisions became law in 1986. The law amended the Employee Retirement Income Security Act of 1974 (ERISA), the Internal Revenue Code and the Public Health Service Act (PHS Act) to provide continuation of employer-sponsored group health plan coverage that is terminated for specified reasons. CMS has jurisdiction to interpret and administer the COBRA law as it applies to state and local government (public sector) employers and their group health plans. Individuals who believe their COBRA rights are being violated have a private right of action. The COBRA law only applies to group health plans maintained by employers with 20 or more employees in the prior year. In addition, the law does not apply to plans sponsored by the governments of the District of Columbia or any territory or possession of the United States, certain church-related organizations, or the federal government. (The Federal Employees Health Benefit Program is subject to generally similar requirements to provide temporary continuation of coverage (TCC) under the Federal Employees Health Benefits Amendments Act of 1988.)

What is the burden of Cobra?

The law plainly places the burden of informing individuals of their COBRA rights on group health plans sponsored by state or local government employers. (Either the employer or plan administrator must provide an initial notice of COBRA rights when an individual commences coverage under the plan and again following a COBRA qualifying event.) A notice of COBRA "rights" must address all of the requirements for which an individual is responsible in order to elect and maintain COBRA continuation coverage for the maximum period. A plan cannot hold an individual responsible for COBRA-related requirements when the plan fails to meet its statutory obligation to inform an individual of those requirements.

How long does it take to notify Cobra of a disability?

The plan cannot require an individual who receives a disability determination under the Social Security Act before experiencing a COBRA qualifying event that is the covered employee's termination, or reduction of hours, of employment to notify the plan of the determination within 60 days of the determination because that requirement expressly applies to a "qualified beneficiary." An individual whose disability determination is issued before the COBRA qualifying event is not a "qualified beneficiary" at the time the disability determination is issued.

How long is a premium due for a health insurance plan?

After you make the initial premium payment, subsequent premiums (usually paid on a monthly basis) are considered to be timely if made by the date due or within a grace period of 30 days after the date due (or longer period as applies to or under the plan). Payment is considered to be made on the date it is sent to the plan.

How long is premium assistance?

Premium assistance was available for up to 15 months, calculated depending on the circumstances. Individuals still receiving 9 months of premium assistance could receive an additional six months of premium assistance (for a total of 15 months coverage).

Can you get continuation coverage for unemployment?

Despite the fact that COBRA and State "mini-COBRA" laws may make continuation coverage available to employees who lose their jobs, as well as their dependents (qualified beneficiaries), many unemployed individuals and family members cannot afford the cost of the continuation coverage. These individuals may qualify for a subsidy under the American Recovery and Reinvestment Act of 2009 (ARRA), and subsequent amendments, to help pay the premium. These are discussed below.

Does Cobra apply to life insurance?

Federal COBRA requirements only apply to employment-related group health plan coverage. They do not apply to individual or association health insurance policies, and they do not apply to any non-health benefits through the employer, such as life insurance.

How long does Cobra last?

Federal coverage lasts 18 months, starting when your previous benefits end. Some states extend medical coverage (but may not include dental or vision) to 36 months. Check with your benefits manager to find out whether your state extends COBRA benefits.

What is cobra insurance?

COBRA is a federal law passed three decades ago to give families an insurance safety net between jobs. It’s available if you’re already enrolled in an employer-sponsored medical, dental or vision plan, and your company has 20 or more employees. Your spouse/partner and dependents can also be included on your COBRA coverage.

What questions to ask before signing up for Cobra?

Here are 5 questions to ask before signing up for COBRA benefits: 1. What is my deadline to enroll in COBRA? Your employer has 44 days from your last day of work or last day of insurance coverage (whichever is later) to send out COBRA information.

Why are Cobra premiums less than open market?

Although that may seem like a lot of money, COBRA premiums are usually less than you’d pay on the open market ― because you’re still benefiting from your company’s group discount.

How long did Dale wait to join his new employer's health insurance?

When Dale, 45, quit his job to take another position, he knew there was a three-month waiting period before he was eligible to join his new employer’s health plan. Around the same time, his friend Debra, 62, was laid off from her job and would soon lose coverage for herself and her spouse. Luckily, Dale and Debra can both remain on their ...

How long do you have to choose a health insurance plan?

You don’t need to wait until Open Enrollment in the fall if you have a qualifying life event, such as leaving a job. You have 60 days to choose a plan, and your benefits will start the first day of the month after you lose your insurance.

Can you change your Cobra plan?

COBRA allows you to keep the exact same benefits as before. No changes can be made to your plan at this time. However, if you’re still on COBRA during the next open enrollment period, you can choose another plan from those your former company offers to employees. The new plan will take effect on January 1. 2.

What is the cobra insurance?

If you’ve lost your job or had your hours reduced, there are options available to workers and their families to maintain health coverage, including the Consolidated Omnibus Budget Reconciliation Act, or COBRA. It provides a way for workers and their families to temporarily maintain their employer-provided health insurance during situations such as job loss or a reduction in hours worked.

How long do you have to enroll in Cobra?

You have 60 days to enroll in COBRA once your employer-sponsored benefits end. Even if your enrollment is delayed, you will be covered by COBRA starting the day your prior coverage ended. You will received a notice from your employer with information about deadlines for enrollment.

Is Cobra the same as employee?

Generally , your coverage under COBRA will be the same coverage you had while you were an employee. This is helpful if you would like to continue to see your same doctors and receive the same health plan benefits.

Can a spouse sign up for Cobra?

Your dependents (i.e., spouse, former spouse or children) are also eligible for COBRA coverage, even if you ( the former employee) do not sign up for COBRA coverage.

How to qualify for Cobra?

According to the Department of Labor, to qualify for COBRA you must fall under three conditions to be considered for coverage:#N#You must have an event that qualifies you for COBRA coverage.#N#COBRA must cover your group health plan.#N#You must be a beneficiary that is qualified for the specific event. 1 You must have an event that qualifies you for COBRA coverage. 2 COBRA must cover your group health plan. 3 You must be a beneficiary that is qualified for the specific event.

How many employees are required to be covered by Cobra?

Consider the following facts to help decide if COBRA coverage is right for you: COBRA covers group health plans only when sponsored by an employer who has at least 20 employees. Additionally, the employees must have been employed for more than 50% of the business days the previous year.

How long do you have to elect Cobra?

The dependent child loses their status and will be eligible for coverage until age 26. If you qualify for COBRA coverage, you have 60 days to elect whether you would like to proceed with the coverage.

What happens to a covered employee?

For a covered employee, if the employee is forced to end their employment for a reason other than gross misconduct. The covered employee dies. There is a divorce/legal separation. The covered employee can qualify for Medicare. The number of hours was reduced for the job.

Do you have to be a beneficiary to qualify for Cobra?

You must be a beneficiary that is qualified for the specific event. There are different types of qualifying events that impact eligibility for COBRA. The time period of COBRA coverage and the qualified beneficiaries will depend on the type of qualifying event.

How long does the COBRA coverage last?

If your major medical coverage ends because your employment ends (other than for gross misconduct), or because your hours are reduced, you and your qualified dependents can keep coverage under the employer’s health insurance for up to 18 months by paying for the full cost of the coverage.

When is a spouse eligible for Cobra?

You are eligible for COBRA coverage if you were covered under the group health plan on the day before your qualifying event. This 1-day rule also applies to your spouse and dependents who were covered under the plan.

What is a qualifying event and a qualifying event notice under COBRA?

A qualifying event causes employees or their dependents to lose their group health coverage but lets them qualify for COBRA coverage. Before a group health plan must offer COBRA coverage, the group health plan administrator must be told about the qualifying event in a qualifying event notice. You can learn more about qualifying events on the US Department of Labor COBRA website.

What is an election notice from COBRA and what do I do when I get one?

Within 14 days of getting the qualifying event notice (above), the employer or health plan administrator must give the person who’s about to lose health insurance written notice of his or her COBRA rights. This written notice is called the election notice. It should contain all of the information you’ll need to understand COBRA coverage so that you can make an informed decision about whether to continue coverage. It should also give you the name of the person who handles COBRA for the health plan (the COBRA administrator) and tell you how to get more information.

What does COBRA stand for?

COBRA stands for the Consolidated Omnibus Budget Reconciliation Act. It gives employees in certain situations the right to pay premiums for and keep the group health insurance that they would otherwise lose after they:

How long do you have to notify Cobra?

The employee or qualified dependents have 60 days after they get the election notice to choose health insurance coverage for themselves under COBRA. The employee or dependent must notify the COBRA administrator listed on their COBRA election notice in writing if they wish to keep their health insurance. The COBRA administrator is the person who keeps up with COBRA benefits for the employer.

What is the Affordable Care Act?

The Affordable Care Act (ACA sometimes called Obamacare) offers affordable health insurance for people, including those with cancer and other serious conditions. It makes sure that most insurance plans cover the health care that cancer patients and survivors might need.

How long can a spouse continue Cobra?

A covered employee's spouse who would lose coverage due to a divorce may elect continuation coverage under the plan for a maximum of 36 months. A qualified beneficiary must notify the plan administrator of a qualifying event within 60 days after divorce or legal separation. After being notified of a divorce, the plan administrator must give notice, generally within 14 days, to the qualified beneficiary of the right to elect COBRA continuation coverage.

What is the law for cobra?

The law generally applies to all group health plans maintained by private-sector employers with 20 or more employees, or by state or local governments. The law does not apply to plans sponsored by the Federal Government or by churches and certain church-related organizations. In addition, many states have laws similar to COBRA, including those that apply to health insurers of employers with less than 20 employees (sometimes called mini-COBRA). Check with your state insurance commissioner's office to see if such coverage is available to you.

What is FMLA coverage?

The Family and Medical Leave Act (FMLA) requires an employer to maintain coverage under any group health plan for an employee on FMLA leave under the same conditions coverage would have been provided if the employee had continued working. Coverage provided under the FMLA is not COBRA coverage, and taking FMLA leave is not a qualifying event under COBRA. A COBRA qualifying event may occur, however, when an employer's obligation to maintain health benefits under FMLA ceases, such as when an employee taking FMLA leave decides not to return to work and notifies an employer of his or her intent not to return to work. Further information on the FMLA is available on the Website of the U. S. Department of Labor's Wage and Hour Division at dol.gov/whd or by calling toll-free 1-866-487-9243.

What is continuation coverage?

If you elect continuation coverage, the coverage you are given must be identical to the coverage currently available under the plan to similarly situated active employees and their families (generally, this is the same coverage that you had immediately before the qualifying event). You will also be entitled, while receiving continuation coverage, to the same benefits, choices, and services that a similarly situated participant or beneficiary is currently receiving under the plan, such as the right during open enrollment season to choose among available coverage options. You will also be subject to the same rules and limits that would apply to a similarly situated participant or beneficiary, such as co-payment requirements, deductibles, and coverage limits. The plan's rules for filing benefit claims and appealing any claims denials also apply.

How long do you have to elect Cobra?

If you are entitled to elect COBRA coverage, you must be given an election period of at least 60 days (starting on the later of the date you are furnished the election notice or the date you would lose coverage) to choose whether or not to elect continuation coverage.

Can you use the Health Coverage Tax Credit for Cobra?

The Health Coverage Tax Credit (HCTC), while available, may be used to pay for specified types of health insurance coverage ( including COBRA continuation coverage).

Can you extend your 18 month coverage?

If you are entitled to an 18 month maximum period of continuation coverage, you may become eligible for an extension of the maximum time period in two circumstances. The first is when a qualified beneficiary is disabled; the second is when a second qualifying event occurs.

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Table of Contents

Background

Premium Assistance

  • In General.Despite the fact that COBRA and State "mini-COBRA" laws may make continuation coverage available to employees who lose their jobs, as well as their dependents (qualified beneficiaries), many unemployed individuals and family members cannot afford the cost of the continuation coverage. These individuals may qualify for a subsidy under the American Recover…
See more on cms.gov

Covered Benefits

  • Federal COBRA requirements only apply to employment-related group health plan coverage. They do not apply to individual or association health insurance policies, and they do not apply to any non-health benefits through the employer, such as life insurance. Qualified beneficiaries are generally entitled to continue the same coverage they had immediately before the qualifying eve…
See more on cms.gov

Periods of Coverage

  • In most cases, COBRA coverage for the covered employee lasts a maximum of 18 months. However, the following exceptions apply: 29-Month Period (Disability Extension):Special rules apply for certain disabled individuals and family members. If a qualified beneficiary is determined to be entitled to disability benefits under Titles II or XVI of the Soc...
See more on cms.gov

Shortened Periods of Coverage

  • Continuation coverage generally begins on the date of the qualifying event and ends at the end of the maximum period. However, a period of coverage may end earlier if: 1. an individual does not pay premiums on a timely basis. 2. the employer ceases to maintain any group health plan. 3. after the COBRA election, an individual obtains coverage with another employer group health pla…
See more on cms.gov

Notices Required of Qualified Beneficiaries

  • An employee or qualified beneficiary must notify the plan administrator of a qualifying event within 60 days after divorce (or legal separation if that results in loss of plan coverage) or a child's ceasing to be covered as a dependent under the plan's rules. Also, a qualified beneficiary must notify the plan administrator within 60 days of those events when they occur during the initial 1…
See more on cms.gov

Paying For Coverage

  • 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. COBRA coverage may be less expensive, though, than individual health coverage. Premiums for COBRA continuation cove…
See more on cms.gov

Other Coverage Considerations

  • In deciding whether to elect COBRA continuation coverage, you should consider all your health care options. 1. For instance, one option that may be available is "special enrollment" in a group health plan sponsored by a spouse's employer, if enrollment is requested within 30 days of loss of your health coverage. (If you decide to elect COBRA coverage under your plan, special enrollmen…
See more on cms.gov

Contact Information

  • If you are unable to find the COBRA-related information you are looking for on this Website, you may e-mail us at [email protected]. Below are other sources of information about continuation coverage benefits, and subsidies and other rights under ARRA. 1. Centers for Medicare & Medicaid Services (CMS). For assistance with questions regarding premium assistance for conti…
See more on cms.gov

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