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Old 05-25-2011, 10:42 AM   #1
shortbun
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COBRA-36 months versus 18?

A friend told me last night that she has COBRA for 36 months. I'm using/paying for COBRA and I was told 18 months. I thought this was a government mandated and administered program. Are there different tiers?
Anyone know anything? I'm going to try to call my administrator today but they are miserably difficult to reach.
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Old 05-25-2011, 10:54 AM   #2
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Quote:
Originally Posted by shortbun View Post
A friend told me last night that she has COBRA for 36 months. I'm using/paying for COBRA and I was told 18 months. I thought this was a government mandated and administered program. Are there different tiers?
Anyone know anything? I'm going to try to call my administrator today but they are miserably difficult to reach.
http://www.dol.gov/ebsa/faqs/faq-consumer-cobra.html

Quote:
Q14: How long does COBRA coverage last?
COBRA establishes required periods of coverage for continuation health benefits. A plan, however, may provide longer periods of coverage beyond those required by COBRA. COBRA beneficiaries generally are eligible for group coverage during a maximum of 18 months for qualifying events due to employment termination or reduction of hours of work. Certain qualifying events, or a second qualifying event during the initial period of coverage, may permit a beneficiary to receive a maximum of 36 months of coverage.

Coverage begins on the date that coverage would otherwise have been lost by reason of a qualifying event and will end at the end of the maximum period. It may end earlier if:
  • Premiums are not paid on a timely basis
  • The employer ceases to maintain any group health plan

After the COBRA election, coverage is obtained with another employer group health plan that does not contain any exclusion or limitation with respect to any pre-existing condition of such beneficiary. However, if other group health coverage is obtained prior to the COBRA election, COBRA coverage may not be discontinued, even if the other coverage continues after the COBRA election.

After the COBRA election, a beneficiary becomes entitled to Medicare benefits. However, if Medicare is obtained prior to COBRA election, COBRA coverage may not be discontinued, even if the other coverage continues after the COBRA election.

Although COBRA specifies certain periods of time that continued health coverage must be offered to qualified beneficiaries, COBRA does not prohibit plans from offering continuation health coverage that goes beyond the COBRA periods.

Some plans allow participants and beneficiaries to convert group health coverage to an individual policy. If this option is generally available from the plan, a qualified beneficiary who pays for COBRA coverage must be given the option of converting to an individual policy at the end of the COBRA continuation coverage period. The option must be given to enroll in a conversion health plan within 180 days before COBRA coverage ends. The premium for a conversion policy may be more expensive than the premium of a group plan, and the conversion policy may provide a lower level of coverage. The conversion option, however, is not available if the beneficiary ends COBRA coverage before reaching the end of the maximum period of COBRA coverage.
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Old 05-25-2011, 11:32 AM   #3
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The general provision is 18 months for loss of employment but there are some events that allow 36 months.
I took this from the COBRA documents I have sitting here on my desk.

In the case of loss of coverage due to employees death, divorce or legal separation , the employee's becoming entitled to medicare benefits, coverage for the spouse/dependents may be continued for up to 36 months
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Old 05-25-2011, 12:27 PM   #4
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My 18 month COBRA ends on July 31st. I called the insurance company asking about a conversion policy and they didn't know what I was talking about. Their solution was to purchase a new policy effective Aug. 1st. I guess I'll keep calling until I get someone who knows more.

My point: If your COBRA is running out within the next 3 months, start your research to avoid an interrpution in coverage.
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Old 05-25-2011, 12:34 PM   #5
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Originally Posted by BunsenH View Post
My 18 month COBRA ends on July 31st. I called the insurance company asking about a conversion policy and they didn't know what I was talking about. Their solution was to purchase a new policy effective Aug. 1st. I guess I'll keep calling until I get someone who knows more.

My point: If your COBRA is running out within the next 3 months, start your research to avoid an interrpution in coverage.
I guess I don't really know what you are talking about either. There is really no "conversion" policy with group health policies. Groups, in a way, "own" their policies so you can't just "covert" it. The option is to get hired somewhere else and go on their plan or take an individual plan. You can keep calling but you are going to get the same answer from everyone.
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Old 05-25-2011, 01:48 PM   #6
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golfgal,

Thanks for your input. I initiated my inquiry to the insurance company based on this paragraph from the above quoted 'rules',

"Some plans allow participants and beneficiaries to convert group health coverage to an individual policy. If this option is generally available from the plan, a qualified beneficiary who pays for COBRA coverage must be given the option of converting to an individual policy at the end of the COBRA continuation coverage period. The option must be given to enroll in a conversion health plan within 180 days before COBRA coverage ends. The premium for a conversion policy may be more expensive than the premium of a group plan, and the conversion policy may provide a lower level of coverage. The conversion option, however, is not available if the beneficiary ends COBRA coverage before reaching the end of the maximum period of COBRA coverage."

and also a letter from the insurance agency stating that I was eligible for a conversion policy.

My confusion remains. I am retired and expect to need an individual policy. However, the mention of this opportunity to 'convert' seemed like a more seamless process (If it exists.)
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Old 05-25-2011, 01:55 PM   #7
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My own personal experience with this (from 5 yrs ago):
I was on layoff from teaching (where I had excellent health insurance). What I was told was that in order to be able to purchase an individual insurance policy through the same company, with the same benefits, no preexisting conditions clause (which was super important since I have a few chronic conditions), I had to pay for my full COBRA time period with absolutely no late/forgotten payments, and could then purchase a policy from that same company with the above stipulations. (I believe mine was BCBS at the time, and it was NOT cheap to COBRA it, but we were desperate to beat the preexisting conditions wait clause that most other policies would have socked us with...)

Hope that was clear, I'm no insurance expert!
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Old 05-25-2011, 01:57 PM   #8
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Quote:
Originally Posted by BunsenH View Post
golfgal,

Thanks for your input. I initiated my inquiry to the insurance company based on this paragraph from the above quoted 'rules',

"Some plans allow participants and beneficiaries to convert group health coverage to an individual policy. If this option is generally available from the plan, a qualified beneficiary who pays for COBRA coverage must be given the option of converting to an individual policy at the end of the COBRA continuation coverage period. The option must be given to enroll in a conversion health plan within 180 days before COBRA coverage ends. The premium for a conversion policy may be more expensive than the premium of a group plan, and the conversion policy may provide a lower level of coverage. The conversion option, however, is not available if the beneficiary ends COBRA coverage before reaching the end of the maximum period of COBRA coverage."

and also a letter from the insurance agency stating that I was eligible for a conversion policy.

My confusion remains. I am retired and expect to need an individual policy. However, the mention of this opportunity to 'convert' seemed like a more seamless process (If it exists.)
They are offering you just that. You can't keep your same policy you have with your company because outside of that company that particular policy does not "exist". Each company makes-up, for lack of a better term, their own policies/coverages, etc. What the conversion in this case means is that you can move from your group policy to an individual policy with no gap in coverage providing you stay current on your COBRA. It means that they can not deny you coverage based on preexisting conditions-not that you get the same policy you had with your former employer.

It should be a fairly seamless process if you stick with the same carrier. You probably will have to fill out an online application, you will get a bunch of emails stating that the policy isn't guaranteed, you have to go through underwriting, blah, blah, blah because they have to send those out, but should in short time get notification that you have been approved for your new policy starting on the day after your current policy expires.
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Old 05-25-2011, 01:57 PM   #9
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Quote:
Originally Posted by BunsenH View Post
golfgal,

Thanks for your input. I initiated my inquiry to the insurance company based on this paragraph from the above quoted 'rules',

"Some plans allow participants and beneficiaries to convert group health coverage to an individual policy. If this option is generally available from the plan, a qualified beneficiary who pays for COBRA coverage must be given the option of converting to an individual policy at the end of the COBRA continuation coverage period. The option must be given to enroll in a conversion health plan within 180 days before COBRA coverage ends. The premium for a conversion policy may be more expensive than the premium of a group plan, and the conversion policy may provide a lower level of coverage. The conversion option, however, is not available if the beneficiary ends COBRA coverage before reaching the end of the maximum period of COBRA coverage."

and also a letter from the insurance agency stating that I was eligible for a conversion policy.

My confusion remains. I am retired and expect to need an individual policy. However, the mention of this opportunity to 'convert' seemed like a more seamless process (If it exists.)
My COBRA docs say the same thing......I am assuming it is the insurance company providing an individual quote that really has nothing to do with what the current plan is other than maybe they don't need the Certificate of Coverage and they already have access to your history so no health questionairre is needed. In no way do I think I would get the benefit of some sort of group rate.
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Old 05-25-2011, 01:59 PM   #10
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Quote:
Originally Posted by yoopermom View Post
My own personal experience with this (from 5 yrs ago):
I was on layoff from teaching (where I had excellent health insurance). What I was told was that in order to be able to purchase an individual insurance policy through the same company, with the same benefits, no preexisting conditions clause (which was super important since I have a few chronic conditions), I had to pay for my full COBRA time period with absolutely no late/forgotten payments, and could then purchase a policy from that same company with the above stipulations. (I believe mine was BCBS at the time, and it was NOT cheap to COBRA it, but we were desperate to beat the preexisting conditions wait clause that most other policies would have socked us with...)

Hope that was clear, I'm no insurance expert!
Terri
Since HIPPA was enacted, as long as you maintain coverage (group or individual) they cannot deny you due to preexisting conditions. The new health reform does away with preexisting condition clauses altogether in the next couple years.
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Old 05-25-2011, 02:02 PM   #11
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Quote:
Originally Posted by mamacatnv View Post
My COBRA docs say the same thing......I am assuming it is the insurance company providing an individual quote that really has nothing to do with what the current plan is other than maybe they don't need the Certificate of Coverage and they already have access to your history so no health questionairre is needed. In no way do I think I would get the benefit of some sort of group rate.
I think you will find that an individual policy is less expensive then a group policy. You may pay more for that policy personally but group policies are usually double or more what an employee pays. Your current insurance company should also send you a certificate of insurance and you could move right from that to an individual policy without going on COBRA at all. Something to look into because there is a good chance you could save a lot of money not going on COBRA-depending on what portion your employer pays.
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Old 05-25-2011, 02:16 PM   #12
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We were on cobra for 18 months since my dh did contract work after getting laid off. Once the 18 months were up last July 31st we switched to private. Our cobra was much cheaper due to the federal subsidy we had but otherwise the private would have been cheaper all along. Dh has a permanent job now so it was just a few months.

Since it looks like you are in MA check out www.mahealthconnector.org There are two programs commonwealth choice for all incomes and commonwealthcare for low incomes. Also look at what hospitals/drs are covered since I remember one was limited just to Boston Medical Center (not convenient to western MA). I believe we had to pay for the upcoming month no later than the 12th of the month prior.
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Old 05-25-2011, 04:29 PM   #13
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California tacks on another 18 months for a total of 36.

http://www.hmohelp.ca.gov/dmhc_consu.../hp_cobra.aspx
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