Cobra eligibility question

[shortbun]

Can I quit and get Cobra or is a layoff required? Anyone know how long one can pay for Cobra? Are benefits exactly the same with Cobra as they are when one is working? Can you tell I'm thinking about quitting my job? I'm really sick of it and my husband hates it too!!! lol! Seriously, I need this info and don't want to tip anyone off at my employer.

 

[C.Ann]

You could when I "quit" a job about 8 years ago.. I had to do it within either 30 or 60 days though (can't remember which) - covered everything my old ins. did (even pre-exisiting conditions) - lasted 18 months - and was quite expensive for just me..

If you google COBRA you might find whatever guidelines are in place as of 2010..

Good luck!

 

[golfgal]

Yes, basically the only time you really can't get COBRA is if you have access to another plan. You will pay both the employee and employer portion of your premium and a 10% upcharge for administration fees. Often is is better to go with an individual plan instead. Keep in mind that COBRA is designed to float coverage for a couple months while people change jobs and are waiting for new plans to start so if that is your case you can "sign up" for COBRA and never really have to pay the premiums unless you use the coverage.

 

[shortbun]

Yes, basically the only time you really can't get COBRA is if you have access to another plan. You will pay both the employee and employer portion of your premium and a 10% upcharge for administration fees. Often is is better to go with an individual plan instead. Keep in mind that COBRA is designed to float coverage for a couple months while people change jobs and are waiting for new plans to start so if that is your case you can "sign up" for COBRA and never really have to pay the premiums unless you use the coverage.

I'm going to go back to school for a year and my husband doesn't have insurance at his 2 man company. I'm also going to get my knees replaced in that year so the insurance has to be in place. I drive a school bus so can not work too soon after the replacements and they are really acting like idiots in my school system lately so I'm really over it. I thought I could do it one more year as planned but this last week of meetings and stupidity have worn me out.

 

[Pakey]

Cobra is still for 18 months. At my company, Cobra for a husband/wife would be +/-$1700 per month.

 

[DebbieB]

I would be very careful to get the information before you quit your job. You will be paying the full cost, it could be very expensive. Plus be sure that you qualify if you just quit.

I found these links:

http://www.dol.gov/ebsa/faqs/faq_consumer_cobra.html
http://www.dol.gov/ebsa/pdf/cobraemployee.pdf

Note the qualifying events:

The following are qualifying events for a covered employee if they
cause the covered employee to lose coverage:
l Termination of the employee’s employment for any reason other
than “gross misconduct”; or
l Reduction in the employee’s hours of employment.

 

[barkley]

Yes, basically the only time you really can't get COBRA is if you have access to another plan. You will pay both the employee and employer portion of your premium and a 10% upcharge for administration fees. Often is is better to go with an individual plan instead. Keep in mind that COBRA is designed to float coverage for a couple months while people change jobs and are waiting for new plans to start so if that is your case you can "sign up" for COBRA and never really have to pay the premiums unless you use the coverage.

is the availability of other insurance a recent change to cobra? cuz when dh quit his job in '06 he had dual coverage (his employer and mine) but he still had the option of continuing through cobra. we just ended up doing cobra for the dental for 6 months but he had the option of continuing the med as well (crazy expensive and not at all worth it).

we did have to pay the premiums each month, weather we used it or not-we had to pay it no later than the payroll date the employer used each month for active employees to pay their premiums, and the paperwork was very specific that if we failed to pay the coverage terminated.

 

[golfgal]

I'm going to go back to school for a year and my husband doesn't have insurance at his 2 man company. I'm also going to get my knees replaced in that year so the insurance has to be in place. I drive a school bus so can not work too soon after the replacements and they are really acting like idiots in my school system lately so I'm really over it. I thought I could do it one more year as planned but this last week of meetings and stupidity have worn me out.

Is your DH one of the owners of that company? If so, it might be a better idea for the company to get a group plan in place. In our area you only need two employees to form a group plan. The premiums would most likely be a business deduction for them and probably cost less.

If you are planning on being on a plan long term, COBRA really isn't always the best way to go. I would look into a group plan for your DH's company or individual plans for you and your DH.

 

[golfgal]

is the availability of other insurance a recent change to cobra? cuz when dh quit his job in '06 he had dual coverage (his employer and mine) but he still had the option of continuing through cobra. we just ended up doing cobra for the dental for 6 months but he had the option of continuing the med as well (crazy expensive and not at all worth it).

we did have to pay the premiums each month, weather we used it or not-we had to pay it no later than the payroll date the employer used each month for active employees to pay their premiums, and the paperwork was very specific that if we failed to pay the coverage terminated.

I am not sure when they added that but now you are not eligible for COBRA if you have access to another group plan. Once you enroll in COBRA and start making payments you do have to keep making them but you have 30 days to turn in your notification that you are accepting the COBRA then another 60 days before your payment is due (covering those days) so if you are moving from one company to another and will have a gap in coverage for say 40 days you send in the info that you are electing COBRA within the first 30 days, then you have 60 more days to send in your payment. As long as you don't use the coverage, you don't really send in that payment. If you do have to use the coverage, mail your payment in that day and all is well. The plan is designed to work this way so you aren't cheating the system in any way.

Also, a "gap" in coverage for portability is considered 63 days with NO coverage but in my example above even if you didn't elect COBRA you would still not have a gap in coverage.

 

[shortbun]

Is your DH one of the owners of that company? If so, it might be a better idea for the company to get a group plan in place. In our area you only need two employees to form a group plan. The premiums would most likely be a business deduction for them and probably cost less.

If you are planning on being on a plan long term, COBRA really isn't always the best way to go. I would look into a group plan for your DH's company or individual plans for you and your DH.

Interesting idea. I have connections to insurance sales but due to my diabetes have been told to keep what I've got until I can find something with good coverage. My current benefits are stellar, nearly unbeatable. We have no lifetime maximums, no co-pays for generic and only $12 for label med, a $5 doctor visit copay, full dental, full eye, great mental health and routine procedures are all covered in full. I do pay $500 per month for family coverage and the Cobra would be approx $1800 or $1300 more per month.

 

[golfgal]

Interesting idea. I have connections to insurance sales but due to my diabetes have been told to keep what I've got until I can find something with good coverage. My current benefits are stellar, nearly unbeatable. We have no lifetime maximums, no co-pays for generic and only $12 for label med, a $5 doctor visit copay, full dental, full eye, great mental health and routine procedures are all covered in full.

Are you prepared to pay more than double what you are paying now for that coverage?

 

[shortbun]

Are you prepared to pay more than double what you are paying now for that coverage?

I'll be making a very detailed financial comparison prior to deciding what my choice will be. Just beginning to collect information. I can certainly cut some fat in spending around here. We've got our bills all paid, no mortgage or credit card debt - one vehicle payment with three newer vehicles. The cost of my pending surgery and the co-pays for that will weigh heavily and could make it actually cheaper to do the Cobra route since I only come out of pocket $500 per surgery with current benefits. Rehab might be needed for the knee replacements so I need to look into that coverage as well. This process will take me a few months. I plan to quit before Thanksgiving so I have some time to look at all sides. thanks for your help! I love people really giving me the hairy eyeball and forcing me to be realistic-seriously!!!!

 

[mamacatnv]

Gross misconduct is very hard to prove and a huge risk for employers to cite just to deny someone COBRA benefits. Therefore COBRA is pretty much always an option unless the company ceases the coverage all together. If a company goes under or discontinues the plan then there is nothing to offer via COBRA.

COBRA is not a federal program it is a Federal Law that mandates what your former employer must do and how they must go about it.

A 10% upcharge would be in violation of the federal law - there is a surcharge of either 2 or 3% for administrative costs (I think it is 2%, my manual is at work) but not 10%.

As a COBRA recipient you are entitled to everything that current employees are entitled to - you can add/subtract dependents etc. same as current employees. You can change coverages as offered during open enrollment periods etc. You can opt to take or not take whatever coverages are offered just like an employee (ie take the medical but not the dental etc unless they are all in 1 plan) The only difference is you WILL NOT receive the benefit of any subsidy that your employer may currently pay on your behalf. Whatever the COBRA premium ends up being is 102% of what it actually costs the former employer. The upcharge is optional BTW and is up to the former employer.

You can stay under the COBRA plan for 18 months with most situations and 36 months with a few others, I think divorce is a 36 month option but a voluntary quit would not be.

Due to your preexisting conditions it does not surprise me that you have been advised to keep the current coverage. You have "stellar" coverage but that type of coverage is very costly - perhaps look into a higher co-pay/deductible plan for the rest of your family members who do not have the burden of the preexisting conditions.

 

[mamacatnv]

As a side note regarding the knee surgery.

Physical Therapy is VERY expensive (I had knee surgery last year)
my insurance offered me unlimited PT as long as Dr. prescribed. Most plans have a limit on the number of visits per event and IMO after what I went thru it is not always enough. I went to PT 3x's a week for 4.5 months - people around me with more severe surgeries were only allowed 24 visits as an example. Many had to cease PT before they really were fully functioning. Something to consider as you shop around plans

 

[shortbun]

As a side note regarding the knee surgery.

Physical Therapy is VERY expensive (I had knee surgery last year)
my insurance offered me unlimited PT as long as Dr. prescribed. Most plans have a limit on the number of visits per event and IMO after what I went thru it is not always enough. I went to PT 3x's a week for 4.5 months - people around me with more severe surgeries were only allowed 24 visits as an example. Many had to cease PT before they really were fully functioning. Something to consider as you shop around plans

Yeah, I know loads of knee replacement recipients; seems to be a very popular surgery of late in my age group. School bus drivers wreck their knees as well and I'm surrounded by loads of those folks with experience. Our insurance has unlimited PT w/doctor prescription so I'm really needing to hang onto to this policy until I'm done with the double replacement. Thanks!

 

[Arielle22]

This is not applicable to the OP but I wanted to add that if the company goes out of business then Cobra is not an option. Also if your company was to entirely eliminate health insurance then Cobra is not an option.

Gross misconduct is considered by the HR community to be something you were arrested for.