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UNDERSTAND
COBRA
 
Key points for Cobra health insurance in Arizona
 
Cobra is essentially continuation of a prior Arizona group coverage that typically lasts 18 months (can be up to 36 months).  You are able to elect Cobra within a 62 day window from your last date of group coverage and continue monthly.  Most people do not realize that they have options to Cobra that can significantly reduce their cost as Cobra is typically very expensive in comparison.  Below are some general points on Cobra coverage followed by some alternatives to reduce cost.
  • Cobra rates are usually 10% higher than what the company was paying for you. 

  • Cobra is paid monthly and can be cancelled monthly as well.

  • If you wait till the end of your 62 day window, you will still need to back-pay first two months of Cobra to bring it current.

  • Dependent costs are typically much higher on a Cobra (Group) plan compared to the employee cost.  Cobra can be split up.  For example, you can get your own Arizona individual plan and keep someone who is unable to qualify (based on health) on Cobra.  Verify with your Cobra administrator/carrier before you try this.

  • If you are unable to qualify for Individual/Family coverage and you exhaust Cobra, then there is typically a HIPAA option available to you.  By law, each carrier must offer their two most popular Individual plans on a Guaranteed Issue basis to HIPAA eligible individuals.  The rates are higher than qualifying based on health but it does provide a back-up option in case you are unable to get your own Individual coverage.  There is also a 62 day window from the last date of Cobra coverage to initiate HIPAA.  Please check with us for HIPAA information and/or rates.

    Instant Individual/Family quote for Cobra alternative here.

     

    Information below provided by http://www.insurance.ca.gov/

    What Is COBRA?
    The Consolidated Omnibus Budget Reconciliation Act (COBRA) is federal law that extends your current group health insurance when you experience a qualifying event such as termination of employment or reduction of hours to part-time status. The extension period is 18 months and some people with special qualifying events may be eligible for a longer extension. To be eligible for COBRA, your group policy must be in force with 20 or more employees covered on more than 50 percent of its typical business days in the previous calendar year.

    Indemnity policies, PPOs, HMOs, and self-insured plans are all eligible for COBRA extension; however, federal government employee plans and church plans are exempt from COBRA. Individual Arizona health insurance is also exempt from COBRA extension, which may be another reason to pursue participation in group health plans, if possible.

    COBRA is regulated by the DOL-EBSA. These agencies can provide further information on the time frames employers and insurance companies/health plans must follow to offer COBRA  coverage for eligible employees and their dependents. Also, information can be furnished on the actions and responsibilities required by employees to participate and elect continuation of benefits under COBRA. When experiencing questions or problems with COBRA, you can reach the appropriate state or federal agency by referencing the contact information available in the resources section of this brochure.

    Important Points to Remember About COBRA:

    • COBRA is federal law that extends your current group health coverage after a qualifying event. Individual policies do not qualify for COBRA.
    • COBRA law applies to group policies in force with 20 or more employees covered on more than 50 percent of its typical business days in the previous calendar year.
    • Indemnity policies, HMOs, PPOs, and self-insured plans are COBRA eligible. Federal government employee plans and church plans are COBRA exempt.
    • You can contact the DOL-EBSA for questions regarding COBRA law.

    Federal COBRA

    Federal COBRA is a U.S. law that applies to employers and group health plans that cover 20 or more employees. It lets you keep your group health insurance when your job ends or your hours are cut. You have to pay the premium but you can keep your insurance for at least 18 months.

    Meet the Deadlines

    • You have 60 days after being notified of your Federal COBRA rights to sign up.
    • If you do not get notification in the mail, call your last employer or health plan.
    • Call the HMO Help Center if you are having problems getting the forms you need.
    • If you miss the deadline, you lose the chance to sign up for Federal COBRA.

    Questions and Answers

    Who can enroll in Federal COBRA?

    • You may be able to get Federal COBRA if you have health insurance through an employer who has 20 or more employees and there is a qualifying event described below.

    A qualifying event means that you lose your health insurance because:

    • The employee's job ends.
    • The employee's hours are cut.
    • You divorce or legally separate from the employee.
    • You are no longer a dependent of the employee.
    • The employee enrolls in Medicare.
    • The employee dies.

    How do I sign up for Federal COBRA?

    • If you leave your job or your hours are cut, you should receive a notice that says you can enroll in Federal COBRA. Within 60 days of the date of the notice, you must tell the health plan in writing that you want to enroll.
    • If you divorce, legally separate, or you can no longer be considered a dependent, you should tell the employer and the health plan to send you the forms you need. Within 60 days of being notified of your right to Federal COBRA, you must tell the health plan in writing that you want to sign up for Federal COBRA.
    • The health plan must then send you a notice that tells you how much the premium is and how to sign up.
    • Make sure you:
      • Send in the application form before the deadline.
      • Send it to the right place.
      • Send the right premium amount.
      • Meet the deadline for paying your premium.

    What are my benefits under Federal COBRA?

    • You have the same benefits as other employees in the same plan.
    • If other employees have open enrollment periods when they can change from one plan to another, you can too.
    • If the employer changes the employees from one plan to another, you change too.
    • You have no restrictions because of pre-existing conditions.
    • If the group plan offers specialized plans, such as dental or vision plans, they must be offered to you also.

    When do Federal COBRA end?

    They end when:

    • The time period ends (up to 18 months of Federal COBRA.
    • You do not pay your premiums on time.
    • The employer no longer offers any health insurance.
    • You move outside the health plan's service area.
    • You enroll in Medicare.
    • You enroll in another health plan.

    Who cannot enroll in Federal COBRA?

    You cannot enroll in Federal COBRA if you:

    • Are enrolled in Medicare.
    • Are fired for gross misconduct.
    • Did not enroll in the time limit.
    • Do not pay your premiums on time.
    • Are covered or become covered by another health plan.

    Can I continue my insurance after Federal COBRA  ends?

    Yes. You have several choices, including HIPAA and Conversion Plans, buying Individual Health Insurance.

    Resources

    Consumer's Guide to Getting and Keeping Health Insurance in Arizona
    Information on COBRA
    www.healthinsuranceinfo.net

    U.S. Department of Labor COBRA
    Information on the Federal COBRA program to help you keep group health insurance if you lose your job or your hours are cut
    1-866-444-3272 (Spanish, Chinese)
    1-877-889-5627 (TTY)
    www.dol.gov/dol/topic/health-plans/Cobra_in_Arizona.htm (Spanish)
    www.dol.gov/ebsa

     

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