Consolidated Omnibus Budget Reconciliation Act (COBRA)

Federal legislation that requires group health plans sponsored by employers with 20 or more employees to offer continuation of health insurance coverage to employees and their dependents after they leave their jobs. Employees must pay the entire premium plus up to 2% administrative costs.

Consolidated Omnibus Budget Reconciliation Act (COBRA)

The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal law passed in 1985 that mandates employers with 20 or more employees to offer continuation of group health coverage to employees and their dependents who lose their health benefits due to specific qualifying events. These events include job loss, reduction in work hours, transition between jobs, death, divorce, and other life events.

Under COBRA, the individual must pay the entire premium for coverage, up to 102% of the cost to the plan. This allows former employees and their dependents to maintain health insurance at group rates, which may be more affordable and accessible than individual health plans.

Examples

  1. Job Loss: An employee who is laid off can choose to continue their existing group health insurance plan through COBRA by paying the necessary premiums.
  2. Reduction in Hours: A full-time employee whose hours are reduced to part-time status may lose eligibility for group health benefits but can elect to continue coverage under COBRA.
  3. Divorce: A spouse who loses coverage due to divorce from an employee can continue the same plan under COBRA.
  4. Death: Dependents of a deceased employee can retain their health insurance coverage temporarily through COBRA.

Frequently Asked Questions

Q1: How long can coverage be continued under COBRA?

A1: Coverage can generally be continued for 18 to 36 months depending on the qualifying event.

Q2: Who is eligible for COBRA coverage?

A2: Employees, their spouses, and dependent children are eligible for COBRA in the event of specific qualifying circumstances such as job loss, reduction of hours, transition between jobs, death, and divorce.

Q3: How does an individual enroll in COBRA?

A3: The employer must provide a COBRA election notice within 14 days of the qualifying event. Individuals must then elect COBRA coverage within 60 days of receiving the notice.

Q4: What is the cost of COBRA coverage?

A4: The cost includes the full premium for the coverage, which the employee must pay, plus up to a 2% administrative fee, totaling up to 102% of the cost.

Q5: What happens if COBRA payments are not made on time?

A5: Coverage can be terminated if COBRA premiums are not paid on time, typically within 30 days of the due date.

Health Insurance Portability and Accountability Act (HIPAA): Federal law that also affects COBRA plans by ensuring the privacy and security of healthcare information.

Affordable Care Act (ACA): Legislation aimed at expanding healthcare coverage, consumer protections, and initiatives to reduce healthcare costs.

Employee Benefits: Non-wage compensation provided to employees in addition to their normal wages or salaries.

Online Resources

  1. U.S. Department of Labor - COBRA
  2. Internal Revenue Service - COBRA Health Coverage
  3. Healthcare.gov - COBRA Coverage & Alternatives

Suggested Books for Further Studies

  1. “Employee Benefits and Executive Compensation” by Adam N. Jorns and Jessica S. Farnsworth
  2. “The Handbook of Employee Benefits: Health and Group Benefits” by Jerry S. Rosenbloom
  3. “Introduction to US Health Policy: The Organization, Financing, and Delivery of Health Care in America” by Donald A. Barr

Fundamentals of Consolidated Omnibus Budget Reconciliation Act (COBRA): U.S. Law Basics Quiz

### Who is generally responsible for paying the premiums under COBRA continuation coverage? - [x] The employee or former employee - [ ] The employer - [ ] The government - [ ] The insurance carrier > **Explanation:** Under COBRA, the individual (employee or former employee) must pay the entire premium plus up to 2% for the administrative costs. ### What is the maximum percentage of the premium an individual must pay for COBRA coverage? - [ ] 90% - [ ] 95% - [x] 102% - [ ] 110% > **Explanation:** Individuals can be required to pay up to 102% of the premium cost for their COBRA coverage (100% of the premium plus a 2% administrative fee). ### For how long can coverage generally be continued under COBRA? - [ ] 6 to 12 months - [x] 18 to 36 months - [ ] 1 to 5 years - [ ] 36 to 72 months > **Explanation:** COBRA coverage can generally be continued for 18 to 36 months, depending on the qualifying event. ### Which of the following is a common qualifying event for COBRA? - [ ] Promotion - [ ] Salary Increase - [ ] Vacation Leave - [x] Job Loss > **Explanation:** Job loss is one of the common qualifying events that make an individual eligible for COBRA coverage. ### What is the purpose of COBRA legislation? - [ ] To provide free health coverage for unemployed individuals - [ ] To offer discount health insurance policies - [x] To allow former employees to continue group health insurance at group rates - [ ] To mandate health screenings for all employees > **Explanation:** The purpose of COBRA is to allow former employees to continue their group health insurance at group rates, making it more affordable. ### COBRA applies to which type of employers? - [x] Employers with 20 or more employees - [ ] Employers with fewer than 10 employees - [ ] Only public sector employers - [ ] Only private sector employers > **Explanation:** COBRA applies to employers with 20 or more employees, which encompasses many medium to large-sized businesses. ### What happens if an individual does not elect COBRA coverage within 60 days? - [ ] They can reapply after 30 days - [ ] Coverage starts automatically - [x] They lose the right to COBRA continuation coverage - [ ] They get coverage for an extra fee > **Explanation:** If an individual does not elect COBRA coverage within 60 days, they lose their right to continue such coverage. ### What kind of events can disqualify someone from continuing coverage under COBRA? - [x] New employment with health benefits - [ ] Moving to a new city - [ ] Marital status change - [ ] Increase in salary > **Explanation:** Securing new employment that provides health benefits can disqualify someone from continuing COBRA coverage. ### What must employers provide to employees regarding COBRA? - [ ] A COBRA manual - [x] A COBRA election notice - [ ] Free health insurance - [ ] Travel allowances > **Explanation:** Employers are required to provide a COBRA election notice to employees who experience qualifying events so they can make an informed decision about continuation coverage. ### Can a spouse be eligible for COBRA continuation coverage? - [x] Yes, if a qualifying event occurs - [ ] No, only employees are eligible - [ ] Yes, but only through a spouse’s employer - [ ] No, only dependents are eligible > **Explanation:** A spouse can be eligible for COBRA continuation coverage if a qualifying event occurs, such as divorce or the death of the employee.

Thank you for exploring our comprehensive coverage on the Consolidated Omnibus Budget Reconciliation Act (COBRA) and testing your knowledge with our detailed quiz! Keep delving into the nuances of employee benefits and health insurance legislation.


Wednesday, August 7, 2024

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