Understanding the Consolidated Omnibus Budget Reconciliation Act – Simplified
COBRA – known as Consolidated Omnibus Budget Reconciliation Act in full – is an act of law that helps those who have already left employment to continue receiving health insurance coverage. The law is generally crucial to those who may want to safeguard their financial and health security even after leaving a job or losing an employed spouse. When one opts to continue with COBRA they don’t have to pick a new plan or transfer medical records. However, there are few basics and requirements in order for one to avail these benefits.
Eligibility Criteria
To qualify for COBRA, one must satisfy several requirements. First, one’s current health plan must be subject to COBRA law. It’s important to note that not all health cover plans are eligible. Another requirement to take note of is that one must be considered a qualified beneficiary in their existing health plan in order to qualify. A qualified beneficiary can be an employee of the sponsoring health plan, spouse, dependent or agent/director (that participated in a health plan) or a retired employee who lost their job as a result of an employer going bankrupt. Lastly, one must have a “qualifying event”. A qualifying event can be: when one is laid off, quits, gets fired, gets terminated or still employed but working hours are reduced causing a loss of health insurance benefits.
How Long It Lasts
An individual may continue enjoying COBRA health-coverage for up-to 18 months. Children or spouses dependent on the employee who become eligible through other reasons other than by employee’s qualifying event can choose to continue the coverage for up-to 36 months – that is if the employee passes on in the course of the 18 months period. In the event the person under the coverage is disabled, COBRA coverage can be lengthened to 36-months.
How It Works
The firm that operates your employer’s health plan is by law supposed to send you several notices concerning your right to receive COBRA cover benefits. Once a qualified event occurs, one is required to enlighten the administrator of the plan. After receiving this notification, the administrator is expected to send-out an election notice to all beneficiaries thereby allowing them 60 days to respond on whether they wish to continue their cover through COBRA or not.
Paying For COBRA
The employee or any of the beneficiaries are required to pay the entire premium to sustain full benefits of the cover. However, from September 2008 the Congress changed (temporarily) this rule to allow one to pay 65% premium in order to enjoy partial subsidy.
Getting Legal Assistance
Because of COBRA’s extensive paper-work and raft of requirements, it is important to seek assistance from professionals. Sometimes, a simple glitch can interfere with the benefits one is entitled to. In case of doubt, one should consult with a professional employment lawyer for further assistance.
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