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COBRA Coverage
In 1986 Congress passed the landmark Consolidation Omnibus Budget Reconciliation Act (COBRA), which provides continuation of group health coverage that otherwise might be terminated.
COBRA provides certain former employees, retirees, spouses, former spouses, and dependent children the right to temporary continuation of healthcare coverage at group rates. Group health coverage for COBRA participants is usually more expensive than health coverage for active employees. Usually the employer pays a part of the premium for active employees; COBRA participants generally pay the entire premium themselves. It is ordinarily less expensive, though, than purchasing individual health coverage.
COBRA coverage is only available when coverage is lost due to certain specific events. For more facts about COBRA coverage and how to apply, please visit the following web pages on the U.S. Department of Labor website.
Eligibility
  • If your healthcare coverage ends because you no longer meet the eligibility requirements or experience another COBRA qualifying event, you may continue this coverage under COBRA.
  • Your covered family members also may continue healthcare coverage under COBRA if your eligibility ends, or if the family member experiences a COBRA qualifying event, even if your coverage does not end. For example:
  • Your spouse can elect COBRA health coverage if you get divorced or legally separated.
  • Your dependent children who lose eligibility through a change in age or marital, educational, or employment status can elect COBRA health coverage.
  • While covered under COBRA, you must notify the HRSC within 31 days after any change in status if you want to make a change in coverage, such as enrolling a new child for COBRA coverage.
  • You may be eligible to extend your COBRA health coverage if you become disabled while you are covered through COBRA. Notify the HRSC within 60 days of being determined totally disabled by the Social Security Administration.
Enrolling
In most cases, you will automatically receive an election form and more information about COBRA health coverage if you become eligible for it. If you are eligible, you must elect COBRA health coverage within 60 days after the event that qualifies you for COBRA coverage. If you miss the 60-day deadline, you cannot enroll.
If a covered family member's coverage ends (such as in the event of a divorce; legal separation or if a dependent child becomes ineligible for corporation healthcare benefits), you are responsible for notifying the HRSC within 60 days, so the person losing coverage can elect COBRA health coverage.
Your COBRA Health Coverage Options
If you are eligible for COBRA coverage, you may continue coverage under any of the following healthcare plans that covered you at the time your corporation coverage ended:
  • Medical
  • Dental
  • Vision
If you were contributing to a Healthcare FSA prior to being covered by COBRA, you may continue to contribute, but only on an after-tax basis and only until the end of the calendar year in which you become eligible for COBRA. If you do this, there is no tax advantage for the new contributions, but you extend your access to the funds already in your account. Remember that you may file claims only for eligible expenses that were incurred while you were contributing.
Cost of COBRA Coverage
If you continue coverage, you will pay the full cost of coverage (your contributions, plus the share of the cost that had been paid by the corporation), plus a 2% administrative charge. Special rules apply if you become disabled.
How Long Coverage Lasts
You can continue health coverage through COBRA for up to 18, 29, or 36 months, depending on how you or your family member becomes eligible.
COBRA health coverage can continue for up to 18 months if you and/or your covered family members would otherwise lose the health coverage you had through the corporation because of:
  • your reduction in hours, or
  • your change from active work status due to your:
  • resignation,
  • termination (except for termination for gross misconduct),
  • disability,
  • leave of absence, or retirement.
For 29 Months
COBRA health coverage can continue for up to a total of 29 months if:
  • within the first 60 days of COBRA health coverage, you or a family member eligible for COBRA was determined to be permanently disabled according to the Social Security Administration, and
  • you or your family member notifies the COBRA administrator before the end of the initial 18-month COBRA period.
For 36 Months
COBRA health coverage for your dependents can continue for up to a total of 36 months from the date any one of the following events occurs:
  • Your death
  • Your divorce
  • Your entitlement to Medicare
  • Your family member ceases to be eligible for coverage
If any of these events occurs while a family member is covered under COBRA (because of an 18-month event described previously), COBRA health coverage may be continued for up to a total of 36 months from the date of the first event.
Eligible for Medicare
If you become entitled to Medicare benefits and then lose medical coverage within the next 18 months because you are terminated or your hours are reduced, your covered family members can purchase COBRA health coverage for a maximum of 36 months from the date you became eligible for Medicare.
When Coverage Ends
COBRA health coverage ends on the earliest of the following:
  • When you or your family member becomes covered under another group health plan that does not contain an exclusion or limitation regarding any preexisting condition you or your family member may have (previous coverage that you had under another group health plan, such as through your spouse's employer, will not terminate or affect your right to elect COBRA health coverage)
  • When you or your family member becomes entitled to Medicare (usually at age 65). COBRA health coverage (excluding dental coverage) ends only for the person who becomes eligible for Medicare; individuals who are not eligible for Medicare may continue their COBRA health coverage. Dental coverage may be continued through COBRA after you become eligible for Medicare.
  • When you do not make payments when required
  • When the corporation health plan is terminated or amended to eliminate coverage and the corporation does not provide a substitute plan to employees
  • When the COBRA continuation period —18, 29 or 36 months — ends
  • For after-tax healthcare FSA contributions, at the end of the calendar year in which those after-tax contributions began