COBRA and Qualifying Events 101
When you find yourself navigating a workplace transition – understanding COBRA — the Consolidated Omnibus Budget Reconciliation Act — and what it can do for you is key. But what is COBRA? Why should the average American care? And what life events, or “qualifying events” may trigger it? This article is meant to provide readers – whether employees, dependents, or business owners – with some of the basics they should know about this topic. For specific advice on your own situation, contact an experienced employment law attorney at the Forsythe Law Firm.
Navigating workplace transitions can be challenging, especially when ensuring continued access to health insurance. This is where COBRA comes into play. COBRA allows employees to maintain their health insurance after specific life events, known as “qualifying events.” Understanding these events is crucial to making informed decisions about your health coverage.
What is COBRA?
Ensuring continued access to health insurance while navigating a workplace transition can be a stressful situation. To help its citizens, in 1985 the federal government enacted The Consolidated Omnibus Budget Reconciliation Act (COBRA). “COBRA” is a federal law designed to protect employees and their families from losing health insurance in the midst of significant life changes.
Cobra will allow those who are part of a qualified group health care plan to temporarily continue their health insurance after experiencing a qualifying event. This continuation of coverage ensures that you and your family won’t suddenly lose access to care during the transitional period.
It is important to note that COBRA only kicks in if and when you are an eligible person and a “qualifying event” occurs.
Who Is Eligible for COBRA?
COBRA is available to:
- Employees enrolled in a qualified group health plan through their employer. (Employers with 20 or more employees are generally required to be COBRA compliant.)
- Spouses of such covered employees.
- Dependent children of such covered employees.
What Is a COBRA Qualifying Event?
A COBRA qualifying event must occur in order to access COBRA coverage. A “qualifying event” is a circumstance that causes a person to lose their group health benefits. These events might include:
- Job Loss (Voluntary or Involuntary)
- Significant reduction in Work Hours
- Divorce or Legal Separation
- Death of the Employee (family members may remain insured)
- Eligibility for Medicare (family members may remain insured)
Duration of COBRA Coverage
COBRA coverage should not be taken as a permanent solution – it is just in place as a temporary stepping stone. How long the coverage will last depends on the qualifying event that triggered it. For:
- Job Loss or Reduction in Hours: Coverage may be provided for up to 18 months.
- Divorce, Legal Separation, Death of the Employee, or Dependent Loss of Coverage: Coverage may be provided for up to 36 months.
There are some exceptions that would allow for coverage to extend beyond these timeframes, as well. This may happen if, for example, you become disabled in the midst of your COBRA coverage. Understanding the at-times complex nature of these timelines is essential to ensuring that you take your next best steps as you move forward. An experienced employment law attorney at the Forsythe Law Firm can help.
Contact the Forsythe Law Firm
The instability that often surrounds COBRA qualifying events can leave you with questions surrounding health insurance, workplace and employment rights – and what on earth the right next steps might be. If you are looking for COBRA support after suffering illegal action, or you are a business seeking to ensure that you follow every tenet of the law, contact an experienced Atlanta employment law attorney at the Forsythe Law Firm today for more information.
Sources:
dol.gov/sites/dolgov/files/ebsa/about-ebsa/our-activities/resource-center/faqs/cobra-continuation-coverage.pdf
cms.gov/cciio/programs-and-initiatives/other-insurance-protections/cobra_qna
