1Can a health insurance policy be cancelled if we submit a lot of claims?
No. Your coverage cannot be canceled because you have a lot of claims. This is called "guaranteed renewability". You have this protection provided that you pay the premiums.
2What if I’ve been recently laid off from a job from a small business in NY?
New York State law provides a continuation right for health plans that are not subject to COBRA. Insurance Law Sections 3221(m) and 4305(e), which set forth the right to continuation, apply to groups of twenty or fewer employees and to cases where an employee is not eligible for COBRA. The rights afforded by these statutes apply only to group policies providing hospital, surgical or medical expense insurance and arise when all or any portion of the insurance on an employee ceases because of termination of employment or membership in the class or classes eligible for coverage under the policy. Employees are entitled to a right of continuation provided that they are not eligible for identical coverage with another plan. The employee must also continuation coverage and pay the applicable premiums within the time frames set forth by the regulations.
3What is COBRA continuation health coverage?
Consolidated Omnibus Budget Reconciliation Act (COBRA) provides continuation of group health coverage for former employees, retirees, spouses, former spouses, and dependent children when coverage is lost due to certain events. Group health coverage for COBRA participants is often more expensive than health coverage for active employees, because the employer often contributed towards part of the premium for active employees, while COBRA participants generally pay the entire premium themselves. It is ordinarily still less expensive, than individual health coverage.
4Who is entitled to benefits under COBRA?
Generally speaking, Employees, spouses and dependent children are entitled to Cobra benefits as a qualified beneficiary.
5How does a person become eligible for COBRA continuation coverage?
be in effect for active employees. COBRA continuation coverage is available upon the occurrence of a qualifying event.
For employees, voluntary or involuntary termination of employment for reasons other than gross misconduct, or change in full time employee status qualifies for COBRA. For spouses, divorce or death would qualify and for children, examples include loss of dependent child status, divorce or death of a parent would qualify.
6What types of group health plans are subject to COBRA?
The law generally covers health plans maintained by private-sector employers with 20 or more employees, employee organizations, or state or local governments. Some states like New York also require coverage be offered for smaller employers under state continuation laws.
7What process must individuals follow to elect COBRA coverage?
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.
A qualified beneficiary must notify the plan administrator of a qualifying event within 60 days after divorce or legal separation or a child’s ceasing to be covered as a dependent under plan rules.
Plan participants and beneficiaries generally must be sent an election notice within 14 days after the plan administrator receives notice that a qualifying event occurred. The individual then has 60 days to elect COBRA continuation coverage and 45 days after electing coverage to pay the premium.
8How long after a qualifying event do beneficiaries have to elect COBRA coverage?
Qualified beneficiaries must be given an election period during which each qualified beneficiary may choose whether to elect COBRA coverage. Each qualified beneficiary may independently elect COBRA coverage. A covered employee or the covered employee’s spouse may elect COBRA coverage on behalf of all other qualified beneficiaries. A parent or legal guardian may elect on behalf of a minor child. Qualified beneficiaries must be given at least 60 days for the election. This period is measured from the later of the coverage loss date or the date the COBRA election notice is provided by the employer or plan administrator. The election notice must be provided in person or by first class mail within 14 days after the plan administrator receives notice that a qualifying event has occurred.
9Can individuals qualify for longer periods of COBRA continuation coverage?
In the event of a disability, COBRA can extend the 18 month period of continuation coverage for a qualifying event. To qualify for additional months of COBRA continuation coverage, the qualified beneficiary must get a ruling from the Social Security Administration that he or she became disabled within the first 60 days of COBRA continuation coverage and meet other guidelines.
If these requirements are met, the entire family qualifies for an additional 11 months of COBRA continuation coverage.
10If I waive COBRA coverage during the election period, can I still get coverage at a later date?
If a qualified beneficiary waives COBRA coverage during the election period, he or she may revoke the waiver of coverage before the end of the election period and elect COBRA coverage.
11Under COBRA, what benefits must be covered?
Qualified beneficiaries must be offered coverage identical to the existing group health plan. A change in the benefits under the plan for the active employees will also apply to qualified beneficiaries.
When does COBRA coverage begin?