Continuation Coverage Explained: Understanding the Duration of COBRA Coverage and Its Peculiarities

September 27, 2023

Fear of losing a job goes hand in hand with the fear of losing health coverage. But there is no need to worry — COBRA has got you covered.

It is no secret that all former employees have to qualify for this continuation option. Even so, it remains an excellent alternative that can help you avoid a crisis triggered by pivotal events like unemployment, the death of a life partner, or divorce.

If you want to keep your employer-provided coverage, COBRA is the way to go. In this article, we will examine the COBRA coverage, its duration, and eligibility criteria more closely.

Program Overview

Extending your employer’s plan can be a number one priority if you get fired, retired, or decide to switch jobs. Group plans typically offer numerous benefits to employees. One of them is the opportunity to save money while making use of health insurance.

If you were happy with your employer-based coverage, it is only natural to look for ways to extend it. But getting COBRA has its ups and downs. The latter generally implies high costs — health insurance premiums mainly. Why? The primary reason is that your company stops covering the customary 82% of your premiums the moment you lose your job and apply for continuation. And once you prove your suitability to enroll in the program, you have to bear all the related costs.

Qualifying for the Program

Qualified beneficiaries have to meet a set of acceptance criteria to qualify. For instance, full-time staff, their children, or significant others can be eligible. But acceptance criteria and program duration typically depend on the state laws and requirements. Besides, former staff members can receive and make use of coverage only after the qualifying event takes place.

What kind of event is it? Basically, it takes place the moment a person loses employer-based coverage. Here are the examples involving staff members:

  • Cutting work hours to a minimum;
  • Firing staff on any grounds except for misconduct.

As mentioned before, spouses and kids can also use the continuation, and here is when:

  • Letting go a worker on any grounds except for misconduct;
  • Getting a divorce or starting a legal separation;
  • The demise of a staff member.

It is important to mention that any staff member looking to enroll in the program had to make use of coverage prior to quitting, being fired, or retiring. It means that a group plan had to be active for more than half of the working days during the preceding year. Otherwise, staff members stand no chance and will have to look for alternatives for the gap period.

Managing the Costs

As mentioned before, the continuation program implies bearing all the costs without the support of your former employer. It might be overwhelming, especially during the COVID. But there are several alternatives you can consider.

The first option is applying for a refundable tax credit. It can absorb up to 72.5% of your premiums. Since its duration was extended until the end of 2021, you still have a chance to qualify and enroll in HCTC.

The second option is the Rescue Plan Act that can help you manage all the COBRA-related costs. In a nutshell, it provides financial support to U.S. citizens experiencing job loss during the pandemic.

Another alternative is to choose a less expensive insurance option instead of a continuation. If you haven’t landed a job yet, you might be stuck with COBRA for quite a while, which implies having to cover excessive costs.

And at this point, the program duration is what you need to take into account. Let’s unpack this a bit more by looking at different duration limits.

How Long is COBRA Coverage Available?

Staff members generally get to use the program for up to 18 months regardless of the reasons for termination. The only exception is gross misconduct. However, different U.S. states have mini continuation plans that have different timelines, terms, and requirements.

Let’s look at some of the examples:

  • New York or California residents get to keep their plans up to 36 months.
  • In Oklahoma, continuations like COBRA last for only 63 days.
  • North Dakota residents can receive a continuation for only 39 days.
  • In Connecticut, you can get a continuation for up to 30 months.

As mentioned before, state laws typically determine the timelines. However, the pandemic caused many changes. If you have any questions or want to check the latest updates to timeframes state-wise, contact your State Insurance Department for additional information.

 

Can COBRA last longer than 18 months?

Yes, it can. But the timeline depends on the state laws. Before applying for the program, you will receive a notice from the company; it will specify the timeframe.

What if the program runs out before I land a new job?

After it runs out, you get to use a Special Enrollment to choose a suitable option through the exchange.

Is there a way to use COBRA for free?

The relief bill allows those suffering from COVID-induced layoffs to use this program for free for up to 6 months.

Can I apply for this program if I am a federal officer?

No, it is not available for federal officers. Generally, federal employees get to use other similar programs. You can contact your personnel office for additional information.

Victoria Berezhetska

Victoria Berezhetska is a Content Lead at Phonexa.com and an expert contributor to American REIA. She has a Bachelor of Science degree in Business Administration, with extensive working experience as a PR specialist and content writer. At American REIA, she helps customers find the right educational material through easily digestible blog posts and buying guides backing their insurance coverage choice. Victoria covers diverse topics around digital and insurance marketing, including auto, home, health, and life insurance.

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