What are COBRA Qualifying Events and The COBRA Notices and Forms

Learn about the COBRA health insurance program, Cobra Qualifying Events and the Required Cobra Notices and Forms in our comprehensive guide.
What is COBRA, Cobra Qualifying Events and The Cobra Notices and Forms

Table of Contents

What is Cobra Coverage, Cobra Qualifying Events and The Cobra Notices and Forms

What is COBRA Insurance Coverage?

COBRA is a health insurance program that allows people to continue their employer provided group health plan coverage after they leave their job.

COBRA can be used by people who are looking for a new job, or by people who have retired or lost their job.

COBRA continuation coverage can be expensive, but it can be a good option for people who need to maintain their health insurance coverage.

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insurance, protection, family, Cobra Qualifying Events and The Cobra Notices and Forms

When was COBRA Continuation Coverage Introduced?

The Consolidated Omnibus Budget Reconciliation Act (COBRA) was introduced in 1986. The COBRA law requires employers with 20 or more active employees to offer continued health insurance coverage to employees (and their families) when certain “qualifying events” occur.

Qualifying events for cobra coverage include, but are not limited to, termination of employment (for reasons other than gross misconduct), reduction in the number of hours worked, and death of the employee.

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Why Should I Elect to Choose Cobra Insurance Coverage?

There are several reasons why a person might choose to elect COBRA Insurance Coverage after loss of a job.

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Continuity of Healthcare.

Cobra qualifying events are those life changes that would normally cause a person to lose their health insurance coverage.

Using COBRA insurance coverage allows a person to continue to see their doctor and fill prescriptions without interruptions. It also helps to maintain continuity of care for serious health conditions.

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Finding a New Health Care Provider

Every insurance plan is different requiring patients to go to certain doctors that are in each insurance plan network. Additionally, different medicines are covered or not covered under different insurance plans.

If a person has a doctor they like and their existing plan covers their doctor visits and all their medicines, having to find and work with a new doctor who is unfamiliar with your particular health situation might be a critical factor in choosing to enroll in COBRA Continuing coverage.

Also, under a new insurance plan maybe some but not all of your current medicines are no longer covered and you will have to pay the full out of pocket amount for certain medicines if you change plans. This could mean hundreds if not thousands of out-of-pocket expenses each month which some people, especially those who just lost their job, cannot do.

Continuation of your current doctor and medicines is a major factor to consider. COBRA continuation coverage gives you some breathing room while you search for alternatives.

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The Time Required to Find a New Plan is Significant

It can take some time and effort to find a new health insurance plan through sites such as healthcare.gov. Often times this is an effort that spans a few days to a few weeks.

Losing a job is a major disruption to a person’s life. Choosing to elect continuation coverage through Cobra, will take some of the stress and strain off newly dismissed employees.

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When does an Employee qualify for COBRA coverage?

In order to be eligible for COBRA, an individual must have been covered by a group health plan on the day before a cobra qualifying event occurred.

Once an individual is determined to be eligible for COBRA, they will have the option to continue their coverage for a specified period of time. The length of time that an individual can continue their coverage will depend on the qualifying event that occurred.

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What are the COBRA Qualifying Events?

There are four types of qualifying events that can trigger an individual’s right to elect COBRA continuation coverage.
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The qualifying events are:

  • Termination or reduction in hours of employment
  • Death of the employee
  • Divorce or legal separation from the employee
  • A dependent child ceasing to be eligible for coverage under the employee’s group health coverage plan.

Not all of these events will entitle an individual to the same length of COBRA coverage. For example, if an individual is terminated from their job (other than for gross misconduct), they will be entitled to continue their health insurance coverage for up to 18 months. However, if an individual’s hours are reduced, they will only be entitled to continue their coverage for up to 36 months.
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What is the Company Required to Do?

When a qualifying event occurs, the employer must provide the affected employees (and their families) with a notice explaining their rights and options under COBRA. One such right is to elect continuation coverage.

What Forms must be provided to a covered employee

There are several different forms that employers need to be aware of when it comes to COBRA. These include the Notice of Commencement of COBRA Continuation Coverage, the Election Notice, and the General Notice.

These forms are used in the administration of COBRA coverage for a covered employee.

Employers should also be familiar with the COBRA Continuation Coverage Premium Reduction Act of 2015, which provides a subsidy for employees who elect to continue their health insurance coverage under COBRA.
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What is the Notice of Commencement of COBRA Continuation Coverage?

The Notice of Commencement of COBRA Continuation Coverage is a confirmation letter indicating that you are enrolled in the COBRA health coverage.

The Notice will indicate when your coverage began, it will explain what continuation coverage is, who is receiving the coverage such as the covered employee, their spouse and any dependents.

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What is the COBRA Election Notice?

The COBRA Election Notice will detail how the qualified beneficiary can activate their cobra election, how they can contact their plan administrator, the premium amount, where the premium amount should be sent as well as the due date of the premium.
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What is the COBRA General Notice?

The General Notice is a general introduction to explain what COBRA is, when continuation coverage becomes available to you, how the coverage is provided, who this coverage is available to, and how you can protect your rights to get COBRA Coverage, and other options. It also explains how to keep in contact with your plan administrator.

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What Actions Must a Covered Employee Take?

A covered employee has 60 days to elect to continue their health insurance coverage.

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Who Pays for COBRA Coverage?

If an employee elects to do so, they will be responsible for paying the entire cobra premium payments, plus a 2% administrative fee.

A person must make their premium cobra payments every month or they risk loosing coverage under the plan.

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What is the Period of COBRA Coverage?

Coverage under COBRA can last for up to 18 months (36 months in some cases).

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Which Health Plans is COBRA Applicable to?

COBRA applies to employer-sponsored health plans, including both private and public sector plans.

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COBRA election periods:

An individual who experiences a qualifying event has 60 days from the date of the event to elect COBRA continuation coverage. If an individual does not elect COBRA within this 60-day period, they will lose their right to continue their health insurance coverage under the plan.

An individual’s COBRA election period begins on the date of the qualifying event. For example, if an employee is terminated from their job on January 1, they would have until March 2 to elect COBRA coverage. If they did not elect COBRA within this 60-day period, they would lose their right to continue their health insurance coverage under the plan.

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How long does COBRA coverage last?

The length of time that an individual can continue their health insurance coverage under COBRA will depend on the qualifying event that occurred.

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What are the Notice requirements for COBRA?

Employers must provide employees with notice of their right to elect COBRA continuation coverage within 14 days of the qualifying event. This notice must be provided to all qualified beneficiaries, including the employee, their spouse, and their dependent children.

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When does Cobra Coverage begin?

Cobra coverage occurs on the date of the qualifying event. For example, if an employee is terminated from their job on January 1, they would have until March 2 to elect COBRA coverage. The coverage is retroactive back to January 2. If they did not elect COBRA within this 60-day period, they would lose their right to continue their health insurance coverage under the plan.
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Who is covered by the Cobra Continuation Coverage?

Cobra continuation coverage is available to the employee and their spouse. In some cases, it may also be available to the dependent children of the employee.

Dependent children who are covered by the employee’s health insurance plan on the date of the qualifying event are eligible for COBRA continuation coverage.

This includes both biological and adopted children, as well as step-children who are financially dependent on the employee. In some cases, foster children may also be eligible for COBRA continuation coverage.

COBRA qualifying events are certain life events that trigger an individual’s right to elect COBRA continuation coverage. Qualifying events include, but are not limited to, voluntary or involuntary termination of employment, reduction in hours worked, death of the covered employee, divorce or legal separation of the covered employee from his or her spouse, and a covered employee becoming entitled to Medicare benefits.

COBRA continuation coverage may also be available to certain dependents of covered employees, such as spouses and children. The COBRA qualifying event must have occurred while the dependent was covered under the employer’s group health plan.

If you experience a COBRA qualifying event, you will generally have 60 days from the date of the event to elect COBRA continuation coverage.

Once you have elected COBRA, you will have up to 18 months (36 months in some cases) of coverage.

COBRA continuation coverage is not free – you will be required to pay the full premium, plus a 2% administrative fee.

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Where do I get the Cobra Election Forms?

There are a few ways that you can obtain the COBRA election forms. The first way is to contact your employer’s human resources department and request the forms.

Another way is to download the forms from the Department of Labor’s website. Finally, you can also request the forms from your health insurance company.

Your employer or the cobra plan administrator has only 45 days to send you the paperwork. You have 60 days to elect coverage once you receive the form.

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What if I do not receive the Cobra Election Forms?

If you do not receive the COBRA election forms within 45 days of your qualifying event, you should contact your employer or the cobra plan administrator. You may also want to contact your state’s department of insurance to file a complaint.

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How much will my Cobra Premium Be?

Cobra Insurance Coverage is a continuation of the insurance plan you had prior to the qualifying event. Therefore, your applicable premium will be same premium amount as it was before you lost your job.

However, you will pay a higher amount than you did while your employment was active. The reason is, the employer is no longer paying a portion of the premium amount and you now have to pay the full applicable premium amount. Your premium will go up but your coverage will remain the same as it was.

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Is COBRA Retroactive?

Yes. Cobra is retroactive to the day after your qualifying event and you have 60 days to sign up for Cobra. This means you will have to pay any back payments to the day after your previous coverage ended to keep your coverage alive.

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Does COBRA have a Premium Grace Period

COBRA allows a 30-day grace period for missed payments.

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What if I Miss a COBRA Payment?

COBRA allows a 30-day grace period for missed payments. However, coverage is automatically terminated if payments lapse longer than 30 days. Once your coverage is terminated, it cannot be reinstated. At that point your only option is to shop for new coverage with a private health insurance provider directly or try healthcare.gov.

How the Mapertunity Experience is Different

When we designed Mapertunity, we optimized for both the candidate and the hiring managers experience.

  • Candidate wants to find jobs that are not only a perfect fit for them but are closest to where they are currently located.
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Mapertunity brings both of these desires together. But it does much more than that. Mapertunity removes all the friction that the current system has built into it. There is no more guessing what candidates are available or what jobs are available. Both available jobs and available candidates in a geographic searchable region are simply displayed on the map to be further explored. In addition, contact information is not hidden for either the Hiring Manager or potential Candidates. There are no hidden barriers, like third party recruiters, between candidates and job posters.

There is currently no system in the world that will tell a company how many actual workers are available within any geographic region in the world.

There is currently no system in the world that will display on a map all the jobs and all the companies hiring in any geographic region in the world.

Just center the map on your location and press SEARCH.

Mapertunity can do this. Mapertunitye will show you where both the jobs and the candidates are located. There is no system that will tell workers which companies are hiring in any geographic radius where the job seeker might be interested in searching.

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We believe the closer a job is to someone’s current location, the more likely they will stay in that job and the closer a worker is to a business, the more likely a business will be able to hold onto those workers. Economist calls this “being sticky”.

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