Understanding COBRA: Continuation of Health Coverage

COBRA, the Consolidated Omnibus Budget Reconciliation Act, provides an important safety net for individuals to maintain their employer-provided health insurance coverage after experiencing certain life events that would otherwise result in loss of coverage.

How COBRA Health Coverage Continuation Works

COBRA applies to most private companies with 20 or more employees, as well as certain state and local government employers. It mandates that group health plan coverage must continue for a specified period after qualifying events, allowing individuals and their families to retain the same coverage they had while employed. Qualifying events include:

  • Termination or reduction of hours for a covered employee.
  • Divorce or legal separation from a covered employee.
  • Death of a covered employee.
  • Covered employee becoming eligible for Medicare.
  • Loss of health coverage for a child or dependent included in the plan.

Eligibility for COBRA Coverage

Eligible individuals for COBRA benefits include employees, their spouses, former spouses, and dependent children. It’s crucial to understand that COBRA coverage is not automatic; individuals must actively elect to continue coverage within a specified timeframe after the qualifying event.

Determining Cost and Coverage

Upon qualifying for COBRA, individuals receive a notification from their employer or plan administrator detailing the cost of premiums and the coverage period. While COBRA premiums can be higher because they include the portion of the premium previously paid by the employer, they typically offer continuity and familiar benefits, which can be crucial during periods of transition.

How to Enroll in COBRA

After a qualifying event, the employer or plan administrator is responsible for notifying the health insurance company, which then sends an election notice to the qualified beneficiary. This notice provides details on how to enroll in COBRA coverage, including deadlines and payment instructions.

Additional Resources

For comprehensive information about COBRA, including rights and responsibilities, individuals can refer to resources provided by the United States Department of Labor (DOL). The DOL oversees COBRA regulations and provides guidance to help individuals navigate the process effectively.

By understanding COBRA provisions and taking timely action, individuals can ensure continuity of health coverage during transitional periods, mitigating the risk of gaps in insurance that could otherwise lead to financial and health-related challenges.

Accessing Healthcare Coverage Under the Affordable Care Act (ACA)

The Affordable Care Act (ACA), also known as «Obamacare,» aims to increase access to health insurance for more individuals. Find a plan on the Health Insurance Marketplace.

Learn About the Health Insurance Marketplace

The Health Insurance Marketplace, commonly referred to as «Obamacare,» allows you to search and compare policies that offer medical, dental, vision, and other coverage options. Determine if you qualify for coverage and enroll in a plan.

Check Your Eligibility for a Health Insurance Marketplace Plan

Find out if you meet the requirements to use the Health Insurance Marketplace. There is no income limit to be eligible. Protections provided by the ACA include:

  • Insurers cannot deny medical coverage based on gender or pre-existing conditions.
  • Coverage does not have annual or lifetime limits.
  • Young adults can stay on their family’s insurance plan until age 26.

Learn more about your rights under the Affordable Care Act.

How to Enroll in a Health Insurance Marketplace Plan

Go to HealthCare.gov to find Health Insurance Marketplace plans in your state. The enrollment process varies by state.

During the annual open enrollment period, each year, you can:

  • Choose a plan for the first time.
  • Continue with your current plan.
  • Make changes to your current insurance plan.
  • Choose a new plan to replace your current one.

If you experience a life event such as moving or the birth of a baby, you may qualify to change your coverage during a special enrollment period.

Learn more about special enrollment periods and find out if you qualify.