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COBRA Premium Reimbursements and How to Qualify

President Biden’s America Rescue Plan has already affected millions of Americans through tax subsidies and stimulus checks. Here’s how it may affect your health insurance this year, especially if you’ve lost your job due to COVID-19.

On March 11th, 2021, President Biden signed the America Rescue Plan into law. A major part of the rescue plan is that it will help qualified people receive assistance with health insurance costs through government subsidies and reimbursement.

Those who are laid off, retired, have experienced reduced hours, or have experienced any other qualifying reason for job loss are eligible for COBRA (the Consolidated Omnibus Budget Reconciliation Act), which is a law that helps people keep their insurance after losing their job. Biden’s plan subsidizes COBRA for those who have lost their job through pandemic-related issues.

Although an employee can qualify for COBRA for a variety of reasons, not all will qualify for an insurance reimbursement.  The federal government is willing to reimburse people for the cost of COBRA if they’ve lost their job due to COVID-19 However, if someone voluntarily left their workplace during the pandemic, they will not qualify for this government assistance.

What President Biden’s New COBRA Program Means

In regular times, COBRA mandates that continuing insurance options for individuals and their families are generally available for up to 18 months (depending on state requirements). Now, the federal government will be subsidizing premium expenses for those who qualify between April 1st to September 30th. This subsidy will cover the insurance premiums, but copays and deductibles would still be left for the former workers to cover. Those that would like retroactive coverage for previous months of coverage will be responsible for the premiums for those months. If retroactive coverage is not desired, the applicant would only be responsible for the premiums moving forward. Because most COBRA options are available from 18 to 36 months, when an employee’s eligibility finishes, the assistance from the federal government also no longer applies.

What Should I Consider Before Using Biden’s Plan?

One factor that will likely disqualify a large group of people from President Biden’s plan is outside enrollment. If someone who lost their job enrolls in insurance outside of COBRA, they would no longer be eligible to transition back into their former workplace’s insurance. Those who become new employees at a workplace that provide health insurance by September 30th are also no longer eligible. There are other restrictions that may hamper applicants in the long run as well- they can all be found here (or you can simply get in touch with one of our experts to discuss your options).

For those who qualify for COBRA, there are some other things to consider. If your insurance coverage comes to term shortly after April, you will want to make sure you have insurance coverage moving forward. Although you will have assistance for those eligible months, you might have a lapse in coverage if your next step is not planned ahead of time. (As a reminder, open enrollment for Affordable Care Act options is now available until May 15th). For those who are enrolled in family plans, any dependents who have turned 26 years old will be responsible for finding their own insurance policy. Another factor to consider is that former spouses of the primary insurance holder are still eligible for the COBRA plan but are responsible for the cost.

What If I Want Other Healthcare Options or Miss the Healthcare Enrollment Period?

For more information about COBRA and how President Biden’s plan affects you, or if you have any other questions or would like to enroll in health insurance, just fill out the short form below or give us a call at 888-375-8879 and we’ll help you get insurance at a rate you can afford.

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Health Insurance After Divorce: What Are My Options?

What Happens To Health Insurance After A Divorce?

Divorce is not an easy topic to talk about. While the questions of “who gets the house”, and “what will happen with the kids?” are obviously the most pressing questions in this situation, divorce is so complex that there are likely hundreds of procedural questions that must be confronted before, during and after a split.

“I’m on my spouse’s health insurance, what will happen to me after we split?”

-The Most Important Divorce Question That No One Thinks About

After a divorce, your former spouse is supposed to cover your health insurance premiums but this only happens for a time. Many people forget that if paying the premiums is not part of the divorce settlements, you will be dropped from the other party’s health insurance plan once the divorce is settled. This is the reason why it is recommended that you know your options before taking up a health insurance plan. Here are a few options that you should consider for health insurance after a divorce.

COBRA and Divorce

A divorce will mean that you are left without your partner’s company health insurance plan. However, COBRA guarantees that you are still entitled to up to 30 months of insurance coverage (the length of the duration of cover is dependent on the circumstances of the divorce.) To qualify for COBRA extended coverage, your ex must be working in a firm with more than 20 employees. 

However, there are some states with mini-COBRA that cover businesses with less than 20 employees. once the COBRA health insurance coverage is terminated, you are required to re-apply for the same within 60 days, only this time you will be the one paying premiums and not your former spouse’s employer. COBRA is appealing to divorced individuals who have already accrued a significant amount of medical expenses as they do not have to start over once their COBRA insurance policy is terminated.

Employer Health Insurance Coverage After Divorce

After a divorce, you are eligible for health insurance from the employer provided that you are under active employment. This option is considered to be more cost-effective compared to COBRA and does not drag your ex-partner into paying your premiums. However, one thing you need to understand is that this option can only be accessed during specific periods during the year. There are unique situations that can give you special enrollment to the Employer Health Insurance Plan as it is the case with a divorce.

How Divorce Affects Obamacare Health Plan

The good thing why you should consider Obamacare health insurance is because even with your employer’s health insurance plan, you are still eligible for the latter. This is because Obamacare is either run by the state or the federal governments. Obamacare is almost similar to the employer health insurance plan since you have 60 days after a divorce to apply for coverage during a period referred to as a special enrollment period. If the 60 days lapse without you having applied for Obamacare health insurance, then you would have to wait for the regular enrollment period that takes place towards the end of the year.

Short Term Health Insurance for Divorcees

Short-term health insurance is a good option for people who cannot afford Obamacare or feel that they are likely to get formal employment in the near future. Of course not every health insurance plan matches your budget for the same. There are a number of things that you should know about short term health insurance one of them being that this option is not for people with pre-existing medical conditions. This blanket exclusion sometimes makes this option unattractive to people since Obamacare and the employer plan allow people with pre-existing conditions to enroll.

In the event of a divorce, finding the right health insurance option should not be problematic as long as you know what to look for in the right plan. Divorce is a difficult event and if your judgment is clouded, chances are that you will rush to choose a health insurance plan that is not ideal for you and your family. For this reason, be sure to use Health Plan Options Today to help find a plan that will usher in the next chapter of your life while guaranteeing good health and wellness. Click the button below or call our hotline at 888-375-8879 to get started on your journey.

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COVID Relief Bill Changes COBRA

What does President Biden’s new bill mean for COBRA insurance?

What Pres. Biden’s New Relief Bill Means for COBRA Insurance?

Just days before he was elected president, Joe Biden outlined his agenda for post-COVID-19 recovery efforts- which include provision of subsidized COBRA coverage. The then president-elect laid out an elaborate plan to address the healthcare challenges by increasing Affordable Care Act subsidies, while paid leave obligations for employers are also set to increase.

COBRA continuing coverage is one of the key highlights of Biden’s administration, with continuing coverage being extended until September 2021. COBRA continuing coverage will address healthcare needs for people who have lost jobs but do not specify the amounts to be allocated to each individual.

Government Will fully cover Laid-off Workers’ COBRA Premiums Through September

Last year, the Democrat-controlled house approved the first Heroes Act thus giving workers who had been laid off, had their hours cut or furloughed by offering them a 100% subsidy.

According to a report by the Kaiser Family Foundation, it is estimated that approximately three million people were laid off and subsequently lost their employer-sponsored health insurance between March and September 2020.

The American Rescue Plan is therefore address healthcare coverage through COBRA. While some COBRA policies during the COVID-19 era was confusing especially to employers, some organizations such as the America’s Health Insurance Plans (AHIP) have been agitating that the government continues with COBRA for several months.

A brief by the Kaiser Family Foundation found that by extending COBRA, the issue of non-insurance would reduce. If COBRA was to be extended up to two years, that period would cost the government an estimated $106 billion. However, extending COBRA could eventually address some of the main concerns that cause high premiums.

How Capping Health Insurance Premiums Will Affect Workers

The plan to cap premiums of the Affordable Care Act by Biden’s administration also seeks to address the issue of high health insurance premiums. The Trump administration was opposed to the Affordable Care Act and even went ahead and reduced premiums when Donald Trump was in office. This led to a decrease in Affordable Care Act marketplace premiums as they were only accessible to people eligible for premium tax credits.

Who are the Major Beneficiaries?

The current administration is hoping that by increasing premium tax credits, more than ten million Americans who rely on premium-related healthcare will spend much less. The new plan by Biden administration is to first address the veterans who took the greatest hit after the COVID-19 pandemic.

Prior to the crisis caused by COVID, the Veteran Health Administration had registered some success with very low non-adherence rate. After the COVID-19 crisis, the Veteran Health Administration was pivotal toward addressing the health crisis, especially toward the communities that were most affected.

The Veteran Health Administration also maintained coverage to veterans after most of them lost their employer-sponsored health insurance. Such efforts are what put the organization under the current financial strain.

What the new Relief Bill Means for COBRA insurance

Thanks to the $1.9 trillion stimulus package, Biden administration will maintain laid-off workers employer-sponsored health insurance up to September. However, what is unclear is how many Americans will benefit from the relief bill.

Some experts agree that the statistics seem to show that while the COBRA extensions have been good on paper, people haven’t been signing up at the rate that policymakers likely hoped for. While lack of knowledge of the ins and outs of this program is probably partially to blame, there are likely other reasons as well.

For one, COBRA can be expensive if you don’t know what your options are. After all, COBRA at its most basic definition means that you’ll have to pay your portion of the premium as well as the employer’s portion. Another issue is that people may not understand the signup process for COBRA and just don’t bother.

In order to find out what your options are or get a walkthrough of COBRA, click the button below or call our hotline at 888-375-8879 to speak directly to an agent..

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This FREE Guide Helps COBRA Make A Lot More Sense.

Let’s face it, COBRA insurance is not necessarily the easiest topic to understand. After all, COBRA is like taxes, financing a car, and so many other parts of “adulting”: there’s no class in high school to teach people about the subject. To be fair, it’s probably a safe bet that COBRA class won’t be taking the place of Algebra anytime soon.

It also doesn’t help that most people who are eligible for COBRA continuation coverage have to learn about the subject at a time when their life is in upheaval and they are trying to get matters back on track. Health insurance is very important, but for many people eligible for COBRA, that concern comes after “getting a new job” and “making sure the bills are paid”.

Most people who have heard of COBRA at least know that it’s a program that helps people to maintain their health insurance coverage after losing a job. Usually, insurance providers or HR departments will provide some basic information about the program after an employee leaves, but those employees often have questions about how COBRA affects them due to their individual situation.

A Guide To Help You

That is why we have created a guide to the top 8 questions people have about COBRA insurance. To write this guide, we surveyed experts and found out the questions they get asked most often about COBRA coverage. We then took the most common questions and explained them in a simple, easy to use format. We’re confident that anyone can go from novice to expert in just minutes after downloading our guide. 

To get your copy, just click the button below. Enjoy and remember, you can get in touch anytime if you have questions about your health insurance options, even if your questions aren’t related to COBRA.

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COBRA Continuation Coverage, Explained.

COBRA is often thought of as the expensive health insurance alternative. That’s not always the case.

How COBRA Health Insurance Works

COBRA, which stands for Consolidated OmniBus Reconciliation Act, allows for a continuation in coverage in relation to an employee’s employer-sponsored health insurance plan even after the employee leaves their job. The health plan is guaranteed regardless of whether the employee left the job voluntarily or not, or if the employee was forced to leave by life certain life experiences.

However, COBRA should not be misinterpreted as a health insurance plan. It is more of a law that converts a group insurance plan into an individual one. Thanks to COBRA regulations, most employers with an excess of 20 employees offer coverage, with the exemption of churches and the federal government. 

What you need to know is that getting the COBRA plan is a little different from getting a plan through your employer since while using the former; you have to cover the full cost of the plan.

How do I Know That I Qualify for the COBRA Plan?

To establish whether your group insurance plan is eligible for COBRA coverage, start by checking at the group’s plan Summary Plan Description. This document is available approximately 90 days after you join the plan. To get cobra insurance, you need to have qualifying events that lead to the loss of your health insurance. The main qualifying event for COBRA coverage is leaving or quitting your job provided that the reasons for leaving are not as a result of gross misconduct. The list below outlines the common cobra qualifying events for COBRA coverage.

  • When you leave or quit your job
  • Termination of your job posting for reasons other than gross misconduct
  • A reduction of your working hours
  • When you lose coverage as a result of being entitled to receive Medicare
  • Divorce or separation from your legal spouse

In the event that your spouse or dependent children lose their coverage from your plan as a result of a legal separation or your death, they are still entitled to COBRA coverage. The same happens for children who are on their parents’ insurance but lose their coverage once they turn 26. Such a child is still a cobra qualified beneficiary.

How Much Does COBRA Cost?

The cost of COBRA coverage is such that you have to pay the full amount of your health insurance plan as well as a 2% administrative cost. This means that COBRA coverage may be more expensive and the expense can even go higher should you consider the plan as a short-term option. In most cases, employers tend to subsidize health insurance cost for their employees. If you find that your health insurance is affordable, it may be that your employer is helping you cover part of the cost (although our agents can help you find affordable options otherwise). This means that before subscribing to cobra health insurance, ensure that you know how much the full cost of your health insurance plan is.

Some employees are eligible for getting assistance to meet their COBRA cost. Those who do qualify for health coverage tax credit. Such employees include those whose employment is terminated as a result of global trade. There are also workers who are entitled to benefits under the Trade Adjustment Assistance (TAA), and some employees who are entitled to pension payments under the Pension Benefit Guaranty Corporation (PBGC).

Is Cobra a Good Alternative?

While COBRA is a good option to retain your employer-sponsored health insurance in the event that you lose your job, make sure that you explore all alternatives before choosing the plan. Our experts can help you find more affordable plans that can suit both individual and family needs. We’d be happy to work with you, just fill out the form below and we’ll get in touch.

Need Health Insurance?

Fill out this form and our experts will contact you to help you get the right insurance for your needs.

    Photo by Tima Miroshnichenko from Pexels

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    Experts Discuss Biden’s Health Insurance Marketplace Enrollment Extension

    Health Insurance Experts share what they think President Biden’s new executive order means for uninsured Americans.

    Last week, President Biden signed an executive order designed to address the impact COVID-19 has had upon Americans’ ability to access healthcare. President Biden’s order reopened the health insurance marketplace for a special enrollment period, and also encouraged all government agencies to review their health insurance policies. 

    According to reports from the Commonwealth Fund research group, nearly 7.7 million Americans lost their job-sponsored health insurance in June 2020 alone, and many others have lost their coverage since then. In contrast, a relatively small number of those people have signed up for COBRA or new health insurance, meaning that millions of Americans are newly uninsured during the greatest health crisis our country has ever seen. Public health analysts believe that disparities like these could combine to create an even worse healthcare crisis than we’re already facing, and agree this is likely at least part of the reasoning beyond Biden’s executive order.

    “…nearly 7.7 Americans lost their job-sponsored health insurance in June 2020 alone.”

    – Commonwealth Fund Report: “How Many Americans Have Lost Jobs with Employer Health Coverage During the Pandemic?”

    Health insurance experts at Health Plan Options Today who work directly with the uninsured have given their take on Biden’s executive order and whether they think it can help the uninsured masses. 

    “The biggest concern folks seem to have is that they can’t afford health insurance- especially considering today’s financial condition- so they often see no way out”, said William G, a representative at Health Plan Options Today. “Of course, this isn’t the case, and we’ve been doing our best to educate people to the contrary. Hopefully the President’s executive order causes people to take another look at health insurance so they can get covered”.

    “The biggest concern folks seem to have is that they can’t afford health insurance… Of course, this isn’t the case”

    William G. HealthPlanOptionsToday Healthcare Expert

    Stephanie A., another representative at Health Plan Options Today, says there are other major issues that have shaped people’s ideas of access to health insurance, especially given the United States’ unemployment rate: “Many people have no idea how COBRA health insurance works, and a lot don’t even know it exists in the first place. They just think that if they lose their job due to COVID, there are no other insurance options available.” Stephanie echoes William’s optimism for Biden’s Plan: “I really hope that the people who lost their jobs and didn’t take advantage of COBRA use the special enrollment period to their advantage.”

    Overall, there is generally support for Biden’s executive order, especially considering 2020’s historically short marketplace insurance enrollment period and low enrollment numbers. Many people who missed the original enrollment period will now have a second chance at enrolling for ACA-based plans in 2021. Perhaps William G. summed it up perfectly: “I think we can all agree that no matter what, a second chance is always nice.”

    Are you insured? To get your own second chance at affordable health insurance, fill out the form below and one of our agents will contact you, or call us at 1-888-375-8879.