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This one is about: COBRA and Health Insurance Portability & Accountability Act


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Comments on COBRA insurance, shared by those on cleft-talk, an email discussion group and researched by the WS insurance consultant, Beth Kaeser.

"I thought COBRA was just for those who were laidoff. I guess not."

COBRA is for anyone who previously had any coverage through their employer and then left their job, be it fired, retired, laid-off, quit. It does not matter. BY LAW, they must offer it to you (although I think there are some exceptions for very small businesses, but they may have changed that). They do not have to offer you as good of a plan that you had, but they must offer base coverage. It is usually very expensive. Like I said earlier, as long as you go from one job to another and coverage does not lapse for more than 63 days, you are also protected by the portability act.

So, if the issue is switching jobs and say there is only a week in between jobs where you are not working, then the pre-existing will still be waived. Does this makes sense???? COBRA is really set up for those who decide that they either will not be getting another job, or if they think it will take a while to find something else. If you have any other coverage, then COBRA does not apply (ie, if you spouse can cover you, then there is no reason to go on COBRA).

We just dealt with all this stuff when I quit my job so abruptly. At the time, I was the one who carried insurance for the family because my plan was better than my husband's, and his plan costs him out of his paycheck (mine did not). When I quit we signed up for his and had a waiting period...but once we were all set up NO pre-existing since I had already been carrying insurance coverage. Then he quit and we got his new job a month later, we should have picked up COBRA on his plan, but never did and so we were uninsured for a month (very scary). In retrospect, I should have picked up the COBRA just to be safe. You also have 45 days to decide whether you want COBRA and if you are looking for work during that time and happen to find a job in 45 days it still sort of acts like a safety net. If you do not find a job, you can elect the COBRA coverage, so it gives you a 45 day lee-way.

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This URL is helpful for those people who are currently under COBRA coverage:

http://he.net/~bsiweb/hipadown.htm

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If you change jobs you have the option to remain on your former employers insurance through Cobra, this will give you time to qualify for the new employers insurance and during OPEN enrollment they can't use the pre-existing condition cop-out. Clinton has been working on that problem. You can always check with the insurance commissioner in your state for the legal terms. COBRA might be restricted to only those people who are terminated. The COBRA plan only lasts 18 months. And the former employer can only charge 2% more than you were paying through your job. I'm on cobra here in Florida. Many states are also trying to eliminate this clause. Insurance companies always cry poverty.

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Here is some more information about COBRA:

Who qualifies for COBRA?

Under COBRA, an employer must give his covered employees (including spouses and dependent children who are covered) the opportunity to elect continuation coverage under an employer maintained group health plan (including plans to which the employer does not contribute financially) after any of the following events:

A. The death of the covered employee;
B. The divorce or legal separation of the covered employee;
C. The termination of the employee's employment, unless for gross misconduct;
D. The covered employee becomes entitled to Medicare;
E. A dependent child ceases to be covered by the plan due to his or her attained age; or
F. The filing by the employer for Chapter I I bankruptcy.

An employer must offer COBRA if they have 20 employees or more on at least 50% of its working days during the year, in order to meet the requirements of IRC Sec. 4980B, also known as COBRA. Failure to comply with COBRA requirements may result in serious penalty.

What does COBRA stand-for? Consolidated Omnibus Reconciliation ACT

There was a time when group health coverage may have been terminated when a worker lost his job or changed employment. That changed in 1986 with the passage of health benefit provisions in the Consolidated Omnibus Budget Reconciliation Act (COBRA). Now, terminated employees or those who lose coverage because of reduced work hours may be able to buy group coverage for themselves and their families for limited periods of time.

If you are entitled to COBRA benefits, your health plan must give you a notice stating your right to choose to continue benefits provided by the plan. You have 60 days to accept coverage or lose all rights to benefits. Once COBRA coverage is chosen, you may be required to pay for the coverage.

COBRA contains provisions giving certain former employees, retirees, spouses and dependent children the right to temporary continuation of health coverage at group rates. This coverage, however, is only available in specific instances. Group health coverage for COBRA participants is usually more expensive than health coverage for active
employees, since usually the employer pays a part of the premium for active employees while COBRA participants generally pay the entire premium themselves. It is ordinarily less expensive, though, than individual health coverage.

More information about COBRA can be found on the Department of Labors Website at the following URL:

http://gatekeeper.dol.gov/dol/pwba/public/pubs/COBRA/cobra95.htm#intro


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