When Does Coverage Under COBRA Begin? When Does It End?COBRA coverage, if the qualified beneficiary elects it, begins on the day coverage would have otherwise been lost. The period of coverage under COBRA varies according to the qualifying event.
- Termination or Reduction of Hours: the period of coverage for the employee, spouse, and dependent child is 18 months.
- Employee Becomes Eligible for Medicare, Divorces/Files for Legal Separation, or Dies: the period of coverage for his or her spouse and dependent child is 36 months.
- Employee's Child Loses "Dependent Child" Status: The dependent child is covered by COBRA for 36 months.
COBRA may end earlier if any of the following things occur:
- Premiums aren't paid on a timely basis
- The employer ceases to maintain any group health plan
- After COBRA election, coverage that is not subject to any limitations is obtained with another group health plan
- After COBRA election a beneficiary becomes entitled to Medicare
What Happens If a Qualified Beneficiary Becomes Disabled?
- If a qualified beneficiary becomes disabled (as determined by the Social Security Act, Title II or Title XVI) within the first 60 days of COBRA coverage, that beneficiary and all qualified beneficiaries in his or her family may be able to extend COBRA for up to an additional 11 months.
- Notice of the determination of disability must be provided within 60 days of the date of the determination and before the end of the 18 month period.
How Much Does COBRA Coverage Cost?
- Premiums vary by policy, but a qualified beneficiary will not pay more than 102% of the cost for similarly situated individuals.
- COBRA premiums may be increased if the cost of the plan increases but must be fixed in advance of each 12 month cycle.
- The plan must allow you to pay monthly, weekly, or quarterly.
- The initial premium must be paid within 45 days of election.
- COBRA beneficiaries remain subject to the rules of the plan and therefore must satisfy all costs related to the plan i.e. copayments and deductibles, and are subject to all limits.
Where Can I Get More Information About COBRA?If you work for a private sector employer, you can contact the U.S. Department of Labor. Either call toll free (866)444-3272, or write to:
U.S. Department of Labor
Employee Benefits Security Administration
Division of Technical Assistance and Inquiries
200 Constitution Avenue NW, Suite N-5619
Washington, DC 20210
If you work for a state or local government, you should contact the Centers for Medicare & Medicaid Services. Either call (410) 786-1565 or write to:
Centers for Medicare & Medicaid Services
Private Health Insurance Group
7500 Security Boulevard
Mail Stop S3-16-16
Baltimore, MD 21244-1850
If you are a Federal employee you are not covered by COBRA. You are covered under a similar plan and should contact the personnel office of your agency for more information.
Disclaimer: Please note that the information on this website is for guidance, ideas and assistance only. Dawn Rosenberg McKay makes every effort to offer accurate advice and information on this site. She is not, however, an attorney, and the content on the site is not to be construed as legal advice. Employment laws and regulations vary by location so check government resources or legal counsel when in doubt about your particular situation.