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Cobra Insurance Rights

More commonly known as COBRA, the Consolidated Omnibus Budget Reconciliation Act of 1986 provides certain former employees, retirees, spouses, former spouses and dependent children the right to continue receiving medical care benefits under an employer-sponsored group health plan at their own expense after they lose eligibility to participate in the plan.

  1. COBRA Eligibility

    • A person can continue receiving health benefits under a group health plan as a COBRA participant if his employer's group health plan is subject to COBRA and if he was enrolled in the plan the day before a COBRA "qualifying event" caused loss of health coverage. The law gives parents who give birth to or adopt a child while a COBRA beneficiary the right to add the child as a dependent under the group health plan, according to U.S. Department of Labor guidelines.

    Qualifying Events

    • In order exercise your right to participate in COBRA your loss of coverage must result from a specific circumstance or "qualifying event" that causes you to lose eligibility in the group health plan. For covered employees such events include receiving a reduced work schedule, retirement, resignation or termination. Other qualifying events include Medicare qualification, divorce, legal separation and death. Additionally, if a child loses "dependent" status, he may continue coverage under the plan as a COBRA participant.

    Choosing COBRA

    • The law requires employers to give each person qualified for COBRA at least 60 days after losing coverage to decide whether to continue benefits as a COBRA participant. Each qualified beneficiary has an independent right to elect continuation coverage. However, the plan can allow the covered employee or her spouse to elect COBRA on behalf of all of the other qualified beneficiaries for the same qualifying event. A minor child's parent or legal guardian may elect COBRA on behalf of the child. If initially you say no to COBRA coverage you have the right to change your mind as long as you do so before the end of the election period.

    Identical Benefits

    • Group health coverage subject to COBRA include benefits for inpatient and outpatient hospital care, physician care, surgery and other major medical treatment. COBRA participants also have the right to extend prescription drug, dental and vision care benefits. The law gives qualified beneficiaries the right to receive health benefits identical to those available to other families or active employees in the group health plan. Changes in the plan benefits for active employees also apply to COBRA participants. COBRA beneficiaries also have the right to make the same choices non-COBRA plan members can make during open enrollment periods, Department of Labor guidelines say.

    Length of Coverage

    • COBRA requires employers to extend benefits for 18 months for an employee and her family who lose coverage after a termination or reduction in work hours. If a second qualifying event occurs or if someone in the family becomes disabled during enrollment as COBRA, the family has the right to extend coverage an additional 18 months. Spouses and dependent children who lose coverage upon a covered employee's death, divorce, legal separation, eligibility to participate for Medicare or loss of dependent status have the right to extend coverage up to 36 months.

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