Is Your Situation a Qualifying Event?
Navigating workplace transitions can be challenging, especially when ensuring continued access to health insurance. This is where COBRA — the Consolidated Omnibus Budget Reconciliation Act — comes into play. COBRA allows employees to maintain their health insurance after specific life events, known as “qualifying events.” Understanding these events is crucial to making informed decisions about your health coverage.
Barrett & Farahany’s employment law attorneys will break down what COBRA is, explain qualifying events, outline the duration of coverage, and offer resources for legal assistance, should you need it.
What is COBRA?
The Consolidated Omnibus Budget Reconciliation Act (COBRA), enacted in 1985, is a federal law designed to protect employees and their families from losing health insurance during significant life changes.
If you are part of a qualified group health plan, COBRA allows you to temporarily continue your health insurance after experiencing a qualifying event. This continuation of coverage ensures that you and your family won’t suddenly lose care during a transitional period.
Whether you’re transitioning jobs, experiencing family changes, or facing new medical circumstances, COBRA safeguards your health coverage until you can establish a new plan.
Who Is Eligible for COBRA?
COBRA is available to:
- Employees enrolled in a qualified group health plan through their employer.
- Spouses of covered employees.
- Dependent children of covered employees.
Employers with 20 or more employees are generally required to comply with COBRA.
What Is a Qualifying Event Under COBRA?
To access COBRA coverage, you must experience a qualifying event—a circumstance that causes the loss of group health benefits.
Each of these events introduces unique challenges, but COBRA provides the necessary cushion to address health insurance concerns during such periods of uncertainty. These events include:
1. Job Loss (Voluntary or Involuntary)
If you lose your job or resign, you may feel immediate concern about how to maintain your health insurance. COBRA ensures you can continue your coverage while you explore your next career opportunity.
2. Reduction in Work Hours
A significant reduction in your hours could result in losing full-time employment benefits, including healthcare. COBRA allows you to maintain your health plan even if your reduced hours no longer qualify you for employer-sponsored benefits.
3. Divorce or Legal Separation
Divorce or legal separation can result in a spouse losing access to the employee’s group health plan. COBRA allows the spouse to continue coverage independently.
4. Death of the Employee
COBRA provides continuity of health insurance coverage for the dependents of an employee who has passed, ensuring family members remain insured during a difficult time.
5. Eligibility for Medicare
If an employee becomes eligible for Medicare and family members lose coverage as a result, COBRA enables these dependents to maintain access to healthcare.
Duration of COBRA Coverage
COBRA coverage is not indefinite but serves as a temporary solution. The duration of coverage depends on the type of qualifying event:
- Job Loss or Reduction in Hours: Coverage lasts for up to 18 months.
- Divorce, Legal Separation, Death of the Employee, or Dependent Loss of Coverage (e.g., child aging out): Coverage can extend up to 36 months.
Some exceptions allow for an extension beyond these durations, such as if you become disabled during your COBRA coverage period. Understanding these timelines is critical to ensuring that you explore and secure long-term health coverage options well before COBRA coverage ends.
How Barrett & Farahany Can Help You
Experiencing a qualifying event can leave you with questions about health insurance, workplace rights, and next steps. If you are seeking support from COBRA after being the victim of an illegal action at the hands of your employer, Barrett & Farahany can help.
Our legal team brings decades of experience, working closely with clients to analyze their unique circumstances and develop effective solutions. We offer dedicated guidance to ensure your rights are protected so you have everything you need from the employer who required you to use COBRA. Contact us today for more information.
