Facts to Help Determine Your COBRA Eligibility
Published October 1, 2020 | By Benefits.gov
Managed by the U.S. Department of Labor, COBRA allows for healthcare benefits to temporarily continue for workers and families during times of transition, job loss, and more. The time period of this extended coverage varies and depends on the reason for the loss of healthcare coverage.
Benefits.gov offers information on different Healthcare and Medical Assistance programs, including COBRA. Consider the following facts to help decide if COBRA coverage is right for you:
- COBRA covers group health plans only when sponsored by an employer who has at least 20 employees. Additionally, the employees must have been employed for more than 50% of the business days the previous year.
- According to the Department of Labor, to qualify for COBRA you must fall under three conditions to be considered for coverage:
- You must have an event that qualifies you for COBRA coverage.
- COBRA must cover your group health plan.
- You must be a beneficiary that is qualified for the specific event.
- There are different types of qualifying events that impact eligibility for COBRA. The time period of COBRA coverage and the qualified beneficiaries will depend on the type of qualifying event. The following are a list of qualifying events that impact COBRA coverage:
- For a covered employee, if the number of hours was reduced at the job
- For a covered employee, if the employee is forced to end their employment for a reason other than gross misconduct
- For the spouse or dependent child of a covered employee (if the covered employee loses coverage and the spouse/dependent child are affected), the spouse and dependent child/children can qualify if:
- The covered employee dies.
- There is a divorce/legal separation.
- The covered employee can qualify for Medicare.
- The number of hours was reduced for the job.
- If the employee is forced to terminate for a reason other than gross misconduct.
- The dependent child loses their status and will be eligible for coverage until age 26.
- If you qualify for COBRA coverage, you have 60 days to elect whether you would like to proceed with the coverage. This 60-day period generally begins on the day you lose coverage.
- Someone is considered a qualified beneficiary if they were covered by the group health plan up until the day before the covered employee loses coverage. Someone is considered a qualifying beneficiary depending on the qualifying event at hand. Usually, a qualified beneficiary means the covered employee, any dependent children, or the employee’s spouse or former spouse.
- The duration of the continued coverage depends on the qualifying event and qualified beneficiaries. Check out page ten of the employer’s guide provided by the Department of Labor, to see the duration period you may qualify for.
Now that you know the basics about COBRA, what can Benefits.gov do for you? As the official benefits website of the U.S. government, we can help you start your benefits search by connecting you to available assistance you may be eligible to receive. Use our Browse by Category feature or take the Benefit Finder questionnaire to see which benefits you may be eligible to receive.
To read this article on the Benefits.gov website, visit: Facts to Help Determine Your COBRA Eligibility