Should you pay for Cobra?
When you lose job-based health coverage and switch to COBRA, you have to pay your COBRA premiums with after-tax money. This means that you lose the tax-free benefit you enjoyed while being employed. In some cases, you may be able to deduct part or all of your COBRA premiums from your taxes. But not everybody is eligible for this deduction.
Can You get Cobra when retiring before eligible for Medicare?
If retiring 18 months before becoming eligible for Medicare, this could be a great option for health insurance for an early retiree. COBRA allows you to keep your current insurance. This means that you don’t have to worry about any changes to your coverage or your network – so you can typically expect to keep your same doctors and pharmacies.
Is COBRA primary over Medicare?
This is true even if your Part A benefits begin before you elect COBRA but you don’t sign up for Part B until later. In this situation, Medicare is always primary to COBRA coverage. If you become entitled to Medicare after you’ve signed up for COBRA, your COBRA benefits cease.
Who is eligible for Cobra coverage?
Your life-event will qualify you for COBRA coverage if you’re the employee and: 3
- You’re laid off.
- You quit.
- You’re fired, but not for gross misconduct like stealing or assaulting the boss.
- Your employment is terminated for any other reason.
- You’re still employed, but your hours are reduced to a level that causes you to lose your health insurance benefit (this can be a voluntary change in hours that you ...
What happens to my spouse when I go on Medicare?
The answer is no. Medicare is individual insurance, so spouses cannot be on the same Medicare plan together. Now, if your spouse is eligible for Medicare, then he or she can get their own Medicare plan.
Can I have both Medicare and COBRA?
If you have Medicare first and then become eligible for COBRA, you can have both Medicare and COBRA. It is important to remember that Medicare pays first and COBRA pays second.
How does Medicare impact COBRA?
If an individual is enrolled in both COBRA continuation coverage and Medicare, Medicare will generally pay first (primary payer) and COBRA continuation coverage will pay second. Certain plans may pay as if secondary to Medicare, even if they are not enrolled in Medicare.
Does COBRA stop when you turn 65?
If you get COBRA Before Medicare If you get COBRA first and then become eligible for Medicare, when you turn 65, COBRA will cease providing primary insurance coverage to you.
How does COBRA and Medicare work together?
If your Medicare benefits (Part A or Part B) become effective on or before the day you elect COBRA coverage, you can continue COBRA coverage as well as having Medicare. This is true even if your Part A benefits begin before you elect COBRA but you don't sign up for Part B until later.
How long can a spouse stay on COBRA?
36 monthsIf the qualifying event is the death of the covered employee, divorce or legal separation of the covered employee from the covered employee's spouse, or the covered employee becoming entitled to Medicare, COBRA for the spouse or dependent child lasts for 36 months.
Is COBRA primary or secondary to Medicare?
COBRA is always secondary to Medicare. This means that it only pays after Medicare pays. If you do not enroll in Medicare when you become eligible for it, it will be as if you have no insurance. If you have Medicare first and then become eligible for COBRA, you can enroll in COBRA.
Can I cover my spouse on COBRA?
Q2: What does COBRA do? COBRA requires continuation coverage to be offered to covered employees, their spouses, former spouses, and dependent children when group health coverage would otherwise be lost due to certain specific events.
Can you have Medicare and employer insurance at the same time?
Can I have Medicare and employer coverage at the same time? Yes, you can have both Medicare and employer-provided health insurance. In most cases, you will become eligible for Medicare coverage when you turn 65, even if you are still working and enrolled in your employer's health plan.
Can my wife get COBRA when I retire?
5 So for example, if your spouse became eligible for Medicare five months before retiring, you'd be able to keep your spousal coverage via COBRA for another 31 months after your spouse retires, since that would be 36 months from when your spouse became eligible for Medicare.
Is Medicare entitlement A COBRA qualifying event?
Medicare entitlement of the employee is listed as a COBRA qualifying event; however, it is rarely a qualifying event. In situations where it is a qualifying event, it is only a qualifying event for the spouse or children that are covered under the group health plan.
Is COBRA Medicare creditable?
Does COBRA Count as Creditable Coverage for Medicare? To avoid penalties with Medicare, you must have creditable coverage. This means coverage that's at least equivalent to Medicare. COBRA does NOT meet these standards.
What happens if you enroll in Cobra?
This means that if your employees enroll in COBRA instead of Medicare, once COBRA coverage ends, they will have to wait until the next annual enrollment period to enroll in Medicare, and they will have to pay late penalties. The late penalties are not minor, either. For Medicare Part B, for example, the monthly premium goes up 10 percent ...
What is the cobra law?
The Consolidated Omnibus Budget Reconciliation Act, or COBRA, is a federal law that requires employers to offer health care continuation to covered employees, their spouses and their dependents after a qualifying event. Enrollees can be required to pay 102 percent of premium costs, which includes the full premium and a 2 percent administrative fee.
How much does Medicare Part B premium go up?
For Medicare Part B, for example, the monthly premium goes up 10 percent for every 12-month period enrollment was delayed. Enrollees have to pay this penalty for the rest of their lives. If your employees are trying to decide between COBRA and Medicare, make sure they understand that they must enroll in Medicare if they want to avoid expensive ...
How to contact CMS about Medicare?
Your employees can contact the CMS Benefits Coordination & Recovery Center at 1-855-798-2627 with questions about Medicare and COBRA. As always, do your best!
Is Medicare Part A free?
Some younger individuals with certain chronic health conditions may qualify as well. Some of your employees may be disappointed to learn that Medicare is not free, although most enrollees qualify for premium-free Medicare Part A.
Is Medicare a qualifying event?
Yes. Employee enrollment in Medicare is considered a qualifying event under COBRA. Imagine this scenario: One of your employees turns 65 and ages into Medicare, but he’s not ready to retire yet. He keeps working. Now he has two health plan options: his group health plan and Medicare.
Is Cobra the same as Medicare?
If someone is enrolled in both COBRA and Medicare, Medicare is the primary insurance. In other words, Medicare pays first, and COBRA may pay some of the costs not covered by Medicare. Certain benefits are not included in traditional Medicare. For example, dental, vision and hearing benefits are generally excluded from Medicare coverage, ...
How many employees can you have with Cobra?
In general, COBRA only applies to employers with 20 or more employees. However, some states require insurers covering employers with fewer than 20 employees to let you keep your coverage for a limited time.
How long does Cobra last?
COBRA coverage generally is offered for 18 months (36 months in some cases). Ask the employer's benefits administrator or group health plan about your COBRA rights if you find out your coverage has ended and you don't get a notice, or if you get divorced.
How long do you have to sign up for Part B?
If you’re eligible for Medicare, you don’t qualify for COBRA coverage without having to pay a premium. You have 8 months to sign up for Part B without a penalty, whether or not you choose COBRA.
What is the number to call for Medicare?
If your group health plan coverage was from a state or local government employer, call the Centers for Medicare & Medicaid Services (CMS) at 1-877-267-2323 extension 61565. If your coverage was with the federal government, visit the Office of Personnel Management.
Do you have to tell Cobra if you are divorced?
You or the covered employee needs to tell the plan administrator if you qualify for COBRA because you got divorced or legally separated (court-issued separation decree) from the covered employee, or you were a dependent child or dependent adult child who's no longer a dependent.
Do you have to tell your employer if you qualify for Cobra?
Once the plan administrator is notified, the plan must let you know you have the right to choose COBRA coverage.
What is Cobra coverage?
This section provides information about COBRA continuation coverage requirements that apply to state and local government employers that maintain group health plan coverage for their employees. Group health plan coverage for state and local government employees is sometimes referred to as “public sector” COBRA to distinguish it from the requirements that apply to private employers. The landmark COBRA continuation coverage provisions became law in 1986. The law amended the Employee Retirement Income Security Act of 1974 (ERISA), the Internal Revenue Code and the Public Health Service Act (PHS Act) to provide continuation of employer-sponsored group health plan coverage that is terminated for specified reasons. CMS has jurisdiction to interpret and administer the COBRA law as it applies to state and local government (public sector) employers and their group health plans. Individuals who believe their COBRA rights are being violated have a private right of action. The COBRA law only applies to group health plans maintained by employers with 20 or more employees in the prior year. In addition, the law does not apply to plans sponsored by the governments of the District of Columbia or any territory or possession of the United States, certain church-related organizations, or the federal government. (The Federal Employees Health Benefit Program is subject to generally similar requirements to provide temporary continuation of coverage (TCC) under the Federal Employees Health Benefits Amendments Act of 1988.)
What happens after a COBRA election?
the employer ceases to maintain any group health plan. after the COBRA election, an individual obtains coverage with another employer group health plan. after the COBRA election, a beneficiary first becomes entitled to Medicare benefits.
How long does it take for a group health plan to notify the administrator of a second qualifying event?
If a second qualifying event is the death of the covered employee or the covered employee becoming entitled to Medicare benefits, a group health plan may require qualified beneficiaries to notify the plan administrator within 60 days of those events, as well.
How long do you have to notify Medicare plan administrators of a qualifying event?
Employers must notify plan administrators of a qualifying event within 30 days after an employee's death, termination, reduced hours of employment, or entitlement to Medicare (when an employee's Medicare entitlement results in loss of plan coverage for the employee's dependents).
How long does Cobra last?
In most cases, COBRA coverage for the covered employee lasts a maximum of 18 months. However, the following exceptions apply: 29-Month Period (Disability Extension): Special rules apply for certain disabled individuals and family members.
What are the second qualifying events for Medicare?
Second qualifying events may include the death of the covered employee, divorce or legal separation from the covered employee, the covered employee becoming entitled to Medicare benefits (under Part A, Part B or both), or a dependent child ceasing to be eligible for coverage as a dependent under the group health plan.
Does Cobra apply to life insurance?
Federal COBRA requirements only apply to employment-related group health plan coverage. They do not apply to individual or association health insurance policies, and they do not apply to any non-health benefits through the employer, such as life insurance.
When is COBRA primary?
Note: If you are eligible for Medicare due to End-Stage Renal Disease (ESRD), your COBRA coverage is primary during the 30-month coordination period. Be sure to learn about ESRD Medicare rules when making coverage decisions.
Is Medicare Part A or Part B?
If you have Medicare Part A or Part B when you become eligible for COBRA, you must be allowed to enroll in COBRA. Medicare is your primary insurance, and COBRA is secondary. You should keep Medicare because it is responsible for paying the majority of your health care costs.
How long is Cobra coverage?
In certain circumstances, if a disabled individual and non-disabled family members are qualified beneficiaries, they are eligible for up to an 11-month extension of COBRA continuation coverage, for a total of 29 months. The criteria for this 11-month disability extension is a complex area of COBRA law. We provide general information below, but if you have any questions regarding your disability and public sector COBRA, we encourage you to email us at [email protected].
What is a Cobra notice?
A notice of COBRA rights generally includes the following information: A written explanation of the procedures for electing COBRA, The date by which the election must be made, How to notify the plan administrator of the election, The date COBRA coverage will begin, The maximum period of continuation coverage, The monthly premium amount,
How long does it take to get a Cobra notice?
Separate requirements apply to the employer and the group health plan administrator. An employer that is subject to COBRA requirements is required to notify its group health plan administrator within 30 days after an employee’s employment is terminated, or employment hours are reduced. Within 14 days of that notification, the plan administrator is required to notify the individual of his or her COBRA rights. If the employer also is the plan administrator and issues COBRA notices directly, the employer has the entire 44-day period in which to issue a COBRA election notice.
How long do you have to notify Cobra?
Qualified beneficiaries must be given an election period of at least 60 days during which each qualified beneficiary may choose whether to elect COBRA coverage.
What is a Cobra election notice?
The COBRA election notice should contain the address to which premium payments should be sent and should be provided by the employer or group health plan administrator along with the amount of the premium due and its due date.
How long does an employer have to issue a Cobra election notice?
If the employer also is the plan administrator and issues COBRA notices directly, the employer has the entire 44-day period in which to issue a COBRA election notice.
What is the cobra?
The Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA) amended the Public Health Service Act, the Internal Revenue Code and the Employee Retirement Income Security Act (ERISA) to require employers with 20 or more employees to provide temporary continuation of group health coverage in certain situations where it would otherwise be terminated.
How long can a spouse continue Cobra?
A covered employee's spouse who would lose coverage due to a divorce may elect continuation coverage under the plan for a maximum of 36 months. A qualified beneficiary must notify the plan administrator of a qualifying event within 60 days after divorce or legal separation. After being notified of a divorce, the plan administrator must give notice, generally within 14 days, to the qualified beneficiary of the right to elect COBRA continuation coverage.
What is the law for cobra?
The law generally applies to all group health plans maintained by private-sector employers with 20 or more employees, or by state or local governments. The law does not apply to plans sponsored by the Federal Government or by churches and certain church-related organizations. In addition, many states have laws similar to COBRA, including those that apply to health insurers of employers with less than 20 employees (sometimes called mini-COBRA). Check with your state insurance commissioner's office to see if such coverage is available to you.
What is FMLA coverage?
The Family and Medical Leave Act (FMLA) requires an employer to maintain coverage under any group health plan for an employee on FMLA leave under the same conditions coverage would have been provided if the employee had continued working. Coverage provided under the FMLA is not COBRA coverage, and taking FMLA leave is not a qualifying event under COBRA. A COBRA qualifying event may occur, however, when an employer's obligation to maintain health benefits under FMLA ceases, such as when an employee taking FMLA leave decides not to return to work and notifies an employer of his or her intent not to return to work. Further information on the FMLA is available on the Website of the U. S. Department of Labor's Wage and Hour Division at dol.gov/whd or by calling toll-free 1-866-487-9243.
How long do you have to elect Cobra?
If you are entitled to elect COBRA coverage, you must be given an election period of at least 60 days (starting on the later of the date you are furnished the election notice or the date you would lose coverage) to choose whether or not to elect continuation coverage.
Can you use the Health Coverage Tax Credit for Cobra?
The Health Coverage Tax Credit (HCTC), while available, may be used to pay for specified types of health insurance coverage ( including COBRA continuation coverage).
Can you extend your 18 month coverage?
If you are entitled to an 18 month maximum period of continuation coverage, you may become eligible for an extension of the maximum time period in two circumstances. The first is when a qualified beneficiary is disabled; the second is when a second qualifying event occurs.
Can you revoke Cobra coverage?
Then, the plan need only provide continuation coverage beginning on the date you revoke the waiver.
Table of Contents
Background
Premium Assistance
Covered Benefits
Periods of Coverage
Shortened Periods of Coverage
Notices Required of Qualified Beneficiaries
Paying For Coverage
Other Coverage Considerations
- In deciding whether to elect COBRA continuation coverage, you should consider all your health care options. 1. For instance, one option that may be available is "special enrollment" in a group health plan sponsored by a spouse's employer, if enrollment is requested within 30 days of loss of your health coverage. (If you decide to elect COBRA covera...
Contact Information