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What Reasons Would Make Me Ineligible for Cobra Insurance?

COBRA Continuation Health Coverage is a health insurance plan that allows individuals an option for continued coverage after they have either resigned or been terminated from employment. The plan gives the employee an opportunity to purchase continued coverage for a period of up to 18 months after the coverage received from the ex-employer stops, and spouses and dependents are also able to receive health insurance under the plan. However, there are some reasons that an individual may be considered ineligible for COBRA insurance.

  1. Gross Misconduct

    • While employees terminated from their jobs are typically allowed to claim coverage under COBRA for themselves and their spouse and children, a worker fired for gross misconduct can be deemed ineligible. Examples of gross misconduct can be theft or assault in the workplace, and employers can use their own judgement to determine if the employee qualifies for ineligibility. The employer will usually give the terminated employee a government form explaining the reasons why the worker has been found ineligible.

    Adult Children

    • While some health insurance plans allow parents to cover adult children up to the age of 26, the COBRA plan only covers children up to the age of 18. The plan does allow for coverage of adult children up to the age of 22 who are enrolled in school or university, as they are still considered dependents under the federal government. Likewise, children who are 17 at the start of COBRA coverage who turn 18 while under the plan are ineligible at the start of the next new year.

    Waiver

    • Following the resignation or termination of an employee, that employee has an election period in which he must choose whether or not to opt in to the COBRA plan. Employees who waive this option during that period are made ineligible for coverage. However, individuals are able to petition to revoke this waiver if they do so while the election period is still open, typically four to six weeks after their employment has ended. Revoking the waiver will only ensure coverage from the date the petition was put forward.

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