COBRA Insurance 101: Q&A with Mark Waterstraat | Benefits PRO

With layoffs, hiring freezes and concerns about an economic slowdown (rightly) continuing to make headlines, it’s important to understand the benefits available to employees, especially if their roles are reduced. . Chief of Customer He spoke to his officer, Mark Waterstraat. Allegeus Also, industry experts in consumer healthcare financing will learn about the health benefits of COBRA for those affected, specifically how it works, who it is for, and how much it costs.

Can you explain what COBRA insurance is and how it works?

COBRA is a federal law that applies to employers with 20 or more employees. This allows individuals covered by their employer’s group health insurance to elect to continue their employer’s health insurance coverage when they have lost coverage due to the termination of their normal relationship with the plan. (For example, termination of employment or reduction of working hours, or loss of relationship with dependents). Employee terminates due to divorce, employee death, or unplanned aging of dependent children).

Who is covered by COBRA insurance and for how long?

Mark Waterstraat, Chief Customer Officer, Alegeus

Each individual who was covered by their employer’s group health plan at the time of the qualifying event (i.e., termination of employment or divorce) shall be covered by the plan (medical and/or dental) when the qualifying event occurred. Some states have special regulations and some other special circumstances, but generally under federal COBRA regulations, eligible events involving employees (such as layoffs or time reduction) can continue for up to 18 months under their employer’s plan. Also, those who have experienced a dependent-type event (such as a divorce or the death of an employee) can continue for up to 36 months.

What are the pros and cons of COBRA insurance?

In general, continuing your employer’s health insurance plan has two major benefits. First, you already know that and know if your doctor is on board with the plan. important in case Second, if you already have high premiums and have met your deductible, you may want to continue your current coverage for the remainder of your plan year rather than starting a new deductible from scratch on a new plan. To do. The cons are usually just the premium cost. Most employers’ health insurance is generous, often overly generous, and the premiums are high. If you continue your employer’s plan under COBRA, you will generally have to pay the full premium yourself, except for the employer contribution that most employers pay for active employee coverage under the plan. there is. Many employees may not realize how much their employer is paying them each month for their insurance premiums until they have verified the full amount of the employee’s premiums themselves.

When is the deadline to sign up for COBRA Insurance?

Federal COBRA regulations generally allow you to elect to continue coverage up to 60 days after the date of the covered event. You can start paying your premium when you choose, or you can choose not to pay and extend the first payment for 45 days. However, it is important to understand that when you make your first premium payment, you must refund the premium up to the date you lost your original coverage to continue coverage thereafter.

What are the typical costs of COBRA insurance and who pays for these costs?

Average monthly health insurance premiums in the United States are about $650 per month for individuals and about $1,850 per month for family insurance (https://www.kff.org/report-section/ehbs-2021-section-1-cost-of-health-insurance/). Again, this is often shocking to many who do not know how much compensation their employers offer active employees. Except in special circumstances such as government or employer subsidy programs (such as during 2021 due to COVID), individuals are responsible for paying the plan’s premiums.

How do I apply for COBRA insurance?

In the event of a covered event (loss of group health insurance coverage due to termination of employment, divorce, etc.), an official letter from your employer or their manager notifying you that you have the right to choose to continue coverage. I need to receive a letter. The selection process, and the cost of premiums. If you think you should have received this letter and you haven’t, please contact your employer’s human resources department.

When will I lose my COBRA eligibility?

If you do not elect to continue within the 60-day election period, you will not be eligible to continue your health coverage under COBRA. Failure to promptly pay the first premium within the outlined timeline. Failure to pay monthly premiums within the grace period. Covered by separate group health insurance. or the end of the maximum duration is reached.

What alternatives to COBRA insurance should individuals consider?

Before choosing to continue health insurance under COBRA, everyone should first understand their options. Depending on your age or living situation, you may be eligible for Medicare, Medicaid, or a government subsidy called the “advanced premium tax credit” for personal health insurance through your state’s health insurance market. If none of these are available, you should research your personal health insurance coverage options, available plan details, and monthly premiums. HealthCare.gov is usually the best place to start. Note the “Quick Start Guide” and “Search for Local Help” links on the right side of the home page.

What is the Mini Cobra Project?

Because federal COBRA regulations apply to employers with 20 or more employees, most states have state laws often referred to as “mini-COBRA” laws. This is very similar to his COBRA and generally applies to employers with 2 of her to 19 of her employees. If you have experienced one of the eligible events listed above, have employer health insurance from your small employer, and have received notice of your right to continue coverage under your small employer plan , read carefully. State mini-COBRA laws may have different maximum terms for election, payment, and continuation than Federal COBRA.

Why is COBRA so expensive?

US medical insurance is expensive because US medical insurance is expensive. most expensive any country in the world. Employer-sponsored health insurance is often more expensive than individual health insurance. This is because employers typically offer more generous plans than buying on their own as part of an overall plan to attract and retain employees.

Can I enroll in COBRA insurance if I quit my job?

If your employer provides group health insurance, and you have 20 or more employees and were covered by your employer’s health plan at the time of your retirement, you will generally continue to be covered under your employer’s plan at the time of your retirement. are eligible to choose One way to know for sure is if she received a notice of her COBRA rights from her employer when she was first hired or when she first enrolled in employer health insurance.

Can I cancel COBRA insurance if I have other insurance?

yes. Your eligibility to continue coverage under COBRA usually ends when you begin coverage under another health plan, so it is usually necessary.

Any other thoughts, tips, or suggestions on this topic?

The two most important tips are to (1) take your time and don’t delay considering your options when you first lose your employer’s health insurance coverage. Losing your employer’s health insurance and becoming eligible for COBRA rarely happens in happy times and will feel like you have far more to worry about than health insurance. Timelines are strict. Contact your insurance company to understand exactly where they stand in covering your deductible for the year. Visit health.gov and take advantage of the opportunity to “get help from your community”. Whether you choose to continue your employer’s coverage under COBRA, purchase an individual plan through healthcare.gov, or discover you are eligible for Medicare or Medicaid under each The time frame allowed for making a decision to opt for coverage is tight. don’t delay. (2) Read all rules carefully. Put reminders in your calendar. I will pay the premium on time. If you don’t make a selection or pay in time, you usually don’t get a second chance.

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