What is COBRA?

   COBRA stands for Consolidated Omnibus Reconciliation Act which Congress passed provisions for in 1986.  The law works to provide continuation of group health coverage that may have been terminated for some reason.  COBRA provides temporary continuation of health coverage at group rates to former employees, retirees, spouses, former spouses and dependent children.  Generally COBRA participants pay the entire premium themselves.  Therefore, group health coverage for COBRA recipients is more expensive than coverage for active employees when the employer pays part of the premium.
   There are certain guidelines that determine eligibility for COBRA regarding coverage, beneficiaries and events.  Groups can qualify for COBRA if the company has 20 or more employees on more than 50% of its normal business days in the previous year.  Both part-time and full-time employees are counted to determine qualification for a group.  To be considered a qualified beneficiary, one must be an"individual covered by a group health plan on the day before a qualifying event who is either an employee, the employee's spouse, or an employee's dependent child."  For some situations, those people related to a retired employee may also be qualified beneficiaries.  Other people who are considered beneficiaries are children born to or placed for adoption and agents, independent contractors and directors who participate in group health plans.   Certain guidelines also apply to determine if events qualify for coverage.  Qualifying events are certain events that would cause an individual to lose health coverage.  After an even is considered a qualifying event, it is determined how long the plan will need to provide health coverage.  Qualifying events include such events as voluntary or involuntary elimination of employment, death, divorce or legal separation or loss of dependent child status.
   A person is considered eligible for COBRA if they were previously enrolled in their employer's health plan.  Qualified beneficiaries under COBRA coverage are offered the same benefits as they would if still under the group health plan.  COBRA coverage always begins on the date that health care coverage would otherwise have been lost by reason of a qualifying event.  Coverage lasts for a maximum of 18 months unless otherwise requested due to certain events.  COBRA beneficiaries may be required to pay for coverage but not more than a specific amount.

 

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