COBRA Insurance
September 10, 2009 in Health Insurance
The Consolidated Omnibus Reconciliation Act or COBRA, became law in 1986. COBRA gives individuals the right to choose to temporarily keep the group health insurance benefits that would otherwise be lose after an employee reduces their working hours, quits their job, or loses their job. It also lets family members choose to keep health insurance after a job loss or other qualifying event that would normally cause them to lose the coverage they have through their employer.
Before this law went into effect, when employees left their companies, they and any covered family members lost their health insurance immediately. If the employee or a family member were ill, they were often not able to get new health insurance because they were already sick. COBRA allows an employee to buy health insurance through the employer even though the person no longer works there or no longer works full time.
COBRA also allows for coverage for up to 18 months in most cases. If the individual is deemed disabled by the Social Security Administration, coverage may continue for up to 29 months. In the case of divorce, coverage may continue for up to 36 months.
COBRA does not apply, on the other hand, if employees lose their benefits coverage because the employer has terminated the plan altogether or if the employer has gone out of business.
COBRA does not, unlike other federal statutes such as the Family and Medical Leave Act (FMLA), require the employer to pay for the cost of providing continuation coverage. Instead it allows employees and their dependents to maintain coverage at their own expense by paying the full cost of the premium the employer previously paid, plus up to a 2% administrative charge (50% for the latter 11 months under the disability extension).
Employees and dependents can also opt for a lesser form of coverage, e.g., to choose continuation coverage under a plan that only covers the employee, but not his or her dependents, or that only provides medical and hospitalization coverage and does not pay for dental work, if those options are available to covered employees.
Employees and dependents lose coverage if they fail to make timely payments of these premiums. Employers are required to inform employees and dependents upon loss of coverage, in writing, by at least fifteen days before the coverage ceases.
