Health Insurance: Part 3 – COBRA Coverage

This is Part 3 of a series on health insurance. Part 1 discussed deductibles. That post discusses  how they affect your plan and costs. Part 2 discussed stop-loss provisions and co-insurance.

The Consolidated Omnibus Budget Reconciliation Act of 1985 or COBRA, is a set of provisions that require some employers (those with 20 or more employees) to continue health insurance coverage for employees after termination of employment.

Termination of Employment

Under COBRA, the employer must offer continued health insurance coverage for 18 months from the date of termination or demotion to part-time.¬† If the employee was fired due to “gross misconduct”, COBRA benefits do not have to be offered. COBRA coverage can be terminated before the 18 month period if any of the following occur:

  • the employer terminates the health plan for all employees
  • the employee neglects to pay the required premium
  • the employee becomes covered under a new medical plan (however, if pre-existing conditions are excluded on the new plan, the employee must be allowed to continue COBRA)

The employer is allowed to require the employee to pay for some of the costs of COBRA coverage. However, they are not allowed to charge more than 102% of the cost of the insurance.

Disability

If termination is due to disability, coverage must be allowed to be continued for up to 29 months. All of the requirements set above are still applicable.

Other Options

There are several other events where an employer must offer 36 months of continued coverage to an employee or their beneficiaries. These events include:

  • death of employee
  • divorce or legal separation of the employee
  • employee’s entitlement to Medicare
  • bankruptcy

Recommendations

COBRA can be a very beneficial for many individuals, especially in these tough times. If you lose your job, check with your previous company about COBRA coverage. The coverage may be more expensive than you are accustomed to, but may be considerably less than if you were to purchase individual coverage. It also allows you to avoid the possibility of having pre-existing conditions placed on your new policy. For example, if you were recently treated for cancer, your new policy may not cover you for those related expenses. COBRA coverage may help ensure that those expenses are covered for a period of time.

Has anyone had a specific COBRA experience they would like to share?

3 thoughts on “Health Insurance: Part 3 – COBRA Coverage

  1. Mrs. Accountability

    When my husband gave notice at his job last February to start his own business, I never thought to ask about COBRA as I had always heard it cost hundreds of dollars a month for coverage. Like, over $1000 a month. Mr. A’s employer neglected to mention he was eligible but finally did in May – we had to make two payments, one for March and April, but it was only $230/month and that was to cover our youngest son, who was still 18 at the time. Now that our son is 19, and no longer eligible to be on his insurance, it has dropped down to $145.

  2. Adam Post author

    @Mrs Accountability – Not a bad deal! Did the company still cover some of the total cost? It sounds like they covered something.

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