cobra insurance benefits

 

                Consolidated Omnibus Budget Reconciliation Act (COBRA)

The landmark COBRA health benefit provisions became law in 1986. The law amends the Employee Retirement Income Security Act (ERISA), the Internal Revenue Code and the  Public  Health  Service Act to provide continuation of employer-sponsored group health coverage  that  otherwise  might  be terminated.

COBRA contains provisions giving certain former employees, retirees, spouses, former spouses, and dependent children the right to temporary continuation of health coverage at group rates. This coverage, however, is only available  when coverage is lost  due to certain specific events. Group health coverage for COBRA participants is usually more expensive than health coverage for active employees,  since usually the employer pays a part of the  premium  for  active   employees  while COBRA participants generally pay the entire premium themselves.   It is ordinarily less expensive, though, than individual health coverage.

The law generally covers group health plans maintained by employers with 20 or more employees
in the prior year.  It applies to plans in the private sector and  those sponsored  by  state and  local governments.  The law does not,  however,  apply to plans sponsored by the  Federal  government
and certain church-related  organizations.  ( The Federal  Employees  Health  Benefit  Program  is
subject to generally similar,  although not parallel,  temporary continuation of coverage   provisions under the Federal Employees Health Benefits Amendments Act of 1988). Under COBRA, a group health plan ordinarily is defined as a plan that  provides   health  care  benefits  for  the  employer's employees and their dependents through insurance or another mechanism such as a trust,  health maintenance organization,   self-funded pay-as-you-go basis,  reimbursement  or  combination  of
these.

Health care benefits provided under the terms of the plan and available to COBRA beneficiaries
may include:

  • Inpatient and outpatient hospital care
  • Physician care
  • Surgery and other major medical benefits
  • Prescription drugs
  • Any other health care benefits, such as dental and vision care.

Life insurance, however, is not covered under COBRA.

Jurisdiction

The Centers for Medicare & Medicaid Services,  Department of Health and Human Services,  has advisory jurisdiction with respect to COBRA as it applies to state and local governmental employers and their group health plans.The Pension and Welfare Benefits Administration, Department of Labor, and the Internal Revenue Service,  Department of the Treasury,  share  jurisdiction  with  respect  to COBRA as it  applies to  private  sector  employers  and  their  group  health  plans.  The  Office  of Personnel Management has jurisdiction with respect to similar continuation of coverage provisions that apply to agencies of the Federal Government. (See Role of Federal Government/More Information).

What You Need to Know

Individuals who work for a state or local  government employer,  and  their  dependents,  should  be aware of their rights regarding COBRA.  Workers need to be aware of changes in health care laws
to preserve their benefit rights.  A good  starting point  is  reading  your  summary  plan  description
(SPD) booklet, if a state or local governmental employer distributes an SPD to its employees. Most of the specific rules on COBRA rights  can be found there or  with  the  person  who  manages  your
health benefits plan.  Also,  be sure to contact the  health  plan  periodically  to  find  out  about  any
changes in the type or level of benefits offered by the plan.  Detailed information regarding  various aspects of COBRA can be found by clicking on the links below.

Coverage

Your Rights

Who is Entitled to Benefits?

Laws

Role of the Federal Government/More Information

Help

 

Healthcare Insurance Quotes

 

 

 


Disclaimer: The above statements are the opionion of the author and do not nessesarily reflect the opionion of Quote
Insurance Health.com. The opionions and examples shown above do not point to any specific insurance companies or
their policies. Cobra is not an insurance plan, but a federal law.
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