COBRA Health Benefits Overview

Who Qualifies for COBRA

COBRA benefits are available to certain individuals who are covered by a group health plan on the day before a qualifying event. Beneficiaries generally include former employees; retirees; and spouses, former spouses, or dependent children of qualified individuals. Directors, agents, and independent contractors may also qualify for COBRA benefits if they participated in a qualifying health plan. A dependent may elect to receive COBRA benefits even if the related employee does not.

Private companies with 20 or more employees, state and local governments, and other employee organizations are generally covered by COBRA.

COBRA “Qualifying Events”

COBRA health insurance is only available under certain specified circumstances, including but not limited to:

 

  • Employment termination on a voluntary or involuntary basis (except in the case of gross misconduct)
  • Reduced hours of employment
  • Medicare benefits take effect
  • Death, divorce, or legal separation of the covered employee

 

Length of COBRA Coverage

The time period during which COBRA is available varies with the type of qualifying event. A plan may extend the benefit period, but cannot shorten the required coverage period. COBRA benefits may be available for 18 to 36 months, depending on the circumstances. Eighteen (18) months is an average benefit period.

The Cost of COBRA Benefits

The beneficiary must pay a monthly premium for COBRA insurance coverage. Many employees face sticker shock when they realize that in addition to the typically small portion of the monthly health payment that was deducted from their paycheck, they now must also pay the portion of the premium previously covered by their employer. In many cases this can be a payment 3-4 times larger than their earlier contribution. Overall, eligible COBRA beneficiaries cannot be required to pay more than 102% of the monthly premium cost, with the 2% representing administrative charges.
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