COBRA - Qualifying Events and Qualifying
Beneficiaries
George Fox - 12/24/2008
COBRA
works for most displaced employees, retirees, their
dependents and spouses, divorced or separated spouses and
dependents who have lost their dependent status.
When an event occurs that might cause an individual to
lose their coverage under a group health insurance
policy, COBRA, which passed into law in
1986, provides the opportunity for those individuals to
continue the previous coverage.
Under
the provisions of COBRA, qualified beneficiaries who
undergo qualifying events are entitled to a
continuation of their current health
insurance, including prescription, dental and
major medical insurance without interruption. The
beneficiary must pay for these COBRA benefits, but there
are many reasons to continue COBRA Health
Insurance.
In
November, 2008, more than 2,300 American companies laid
off more than 50 employees each. These staggering
numbers may well continue into 2009. COBRA protects
these workers and their families. With the
ever-rising cost of health care, most individuals and
families need health insurance more than ever.
Unfortunately many qualified beneficiaries are either
unaware of the rights or do not understand how to keep
their health insurance when qualifying events
occur.
Under
COBRA, a qualified beneficiary is an individual who was
covered by a group health plan on the day before the
occurrence of a qualifying event.
The qualified beneficiary must be either the employee,
the spouse of the employee or the employee’s
dependent. If an individual is covered by a group
policy but is a subcontractor, agent or director, they
may also be entitled to continued health insurance
through COBRA.
A
qualified event is an event that could cause a covered
employee to lose their health insurance. The
qualifying event determines who the qualified
beneficiaries are and the amount of time for which the
COBRA Health Insurance is available to the
beneficiary. Following is a list of qualifying
events for qualified beneficiaries:
Qualifying Event for Employees:
- The employee voluntarily terminates employment
for reasons other than gross misconduct.
- The employee is terminated for reasons other than
gross misconduct.
- The employee’s work hours are reduced
significantly
Qualifying Events for Spouses:
- Voluntary termination of employment by a covered
employee for reasons other than gross
misconduct.
- Involuntary termination of employment by a
covered employee for reasons other than gross
misconduct.
- Significant reduction in work hours for the
covered employee.
- Entitlement of the covered employee for Medicare
benefits.
- Either divorce or legal separation from a covered
employee.
- Death of a covered employee.
Qualifying Events for a Dependent
Child:
- Loss of dependent child under the rules of the
health insurance plan.
- Voluntary termination of employment by a covered
employee for reasons other than gross
misconduct.
- Involuntary termination of employment of a
covered employee for reasons other than gross
misconduct.
- Reduction in work hours for the covered
employee.
- Entitlement of the covered employee for Medicare
benefits.
- Either divorce or legal separation of the covered
employee.
- Death of the covered employee.
COBRA
offers continued health insurance for qualified
beneficiaries in each of the above mentioned
events. In most cases, the insurance can be used
for a minimum of 18 months, and, in certain
circumstances, the coverage can be
extended.
Beneficiaries
of a qualifying event can continue uninterrupted health
insurance without fearing exclusion due to pre-existing
conditions. While the beneficiary must pay for the
insurance, it often serves as a bridge between coverage
at a new job or until work is
located.
Today,
employees usually must work for a defined time period
before group health insurance is offered. Many
companies are reducing their contributions to employee
health plans. Persons seeking advice about COBRA
health insurance or the enrollment process are prudent to
seek assistance from a COBRA expert who can explain the
qualifications and all procedures.
George L. Fox, LUTCF, serves as Vice President of Planning
Financial Futures, Inc. He is a lifetime resident of Long
Island and lives in Huntington with his wife, Vicki, and their
three children. George is a graduate of the State University of
New York, NYIT and the College for Financial Planning.
|
Cobra Help Center are experts in the field of Major
Medical Insurance when coming off of COBRA. Our
dedicated team of underwriters, brokers and former
COBRA administrators work with you to apply federal
laws and state statutes to force insurance carriers
to give you continued Major Medical when your COBRA
Insurance ends. |
Source: http://www.cobrahelpcenter.com
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