If you’re a U.S. worker who has recently lost their job or had their hours reduced, you may be eligible for COBRA(Consolidated Omnibus Budget Reconciliation Act) or Cal-COBRA Coverage. These programs provide temporary continuation of your health coverage while employed, allowing you to maintain your health benefits until you find new employment or alternative Coverage.
What is COBRA?
COBRA, which stands for Consolidated Omnibus Budget Reconciliation Act, is a federal law that allows you and your dependents to keep your employer-provided health coverage for up to 18 months after your employment ends.
Will the employer be responsible for paying part of my premium under COBRA?
You will be responsible for paying the full cost of the premium, including the portion your employer previously paid. Additionally, you will have to pay two percent administration charge.
What is Cal-COBRA?
Cal-COBRA is the California version of COBRA and allows eligible employees to continue their health coverage for up to 36 months. Like COBRA, you will be responsible for paying the full premium cost and a two percent administration charge.
It’s important to note that not all employers must offer COBRA or Cal-COBRA Coverage. Employers with fewer than 20 employees are exempt from COBRA, while Cal-COBRA applies to all employers with 2 to 19 employees.
What are the Eligibility for COBRA
Eligibility for COBRA applies to:
- covered employees
- former employees
- spouses
- former spouses and
- dependent children.
If you’re eligible for COBRA or Cal-COBRA, you’ll receive a notice from your employer with information on how to enroll. It’s important to act quickly, as you typically only have 60 days to enroll once you receive the notice.
Duration of COBRA Coverage Based on Qualifying Event
The type of qualifying event that occurs determines the maximum period of COBRA coverage available:
- Job loss or reduction in hours: 18 months of Coverage for the employee, spouse, and dependents.
- Voluntary or involuntary termination of employment (for reasons other than Dependents’ gross misconduct): 36 months of Coverage for the spouse and dependents.
- Death of covered individual: 36 months of Coverage for the spouse and dependents.
- Legal separation or divorce: 36 months of Coverage for the spouse and any dependent children.
- Enrollment in Medicare:36 months of Coverage for the spouse and dependent children.
- Loss of dependent coverage:36 months of Coverage for formerly dependent children, such as adult children who recently turned 26.
Takeaway
COBRA and Cal-COBRA coverage are important programs that allow eligible individuals to maintain their health insurance coverage for a limited period after a qualifying event, such as job loss or reduction in hours.
Employers who offer group health benefits must give a general notice about COBRA rights. This can be done by including a notice in the Summary Plan Description distributed in the first 90 days of coverage. It’s important to meet these obligations and provide adequate information to employees. If you have questions or need help navigating COBRA and Cal-COBRA coverage, contact our Skyline Benefit Expertise for assistance.
Need Help with Group Health Insurance
Skyline Benefit is an independent health insurance broker in Fullerton, CA that offers affordable and flexible group health insurance options. Selecting the best group health insurance plans can be overwhelming; our mission is to simplify the process and help our clients every step of the way.
Schedule a consultation today. Call us at: (714) 888-5112