Understanding who can get continuing coverage via COBRA


For New York union members who are facing the prospect of needing to get healthcare in the interim when there will be an interruption should know about the Consolidated Omnibus Budget Reconciliation Act (COBRA). COBRA can be an essential benefit. However, many people might not know who is eligible to receive COBRA. Knowing who is entitled is the first step toward using it. If there are issues with eligibility and those who should be eligible are not being given the right to COBRA, it might be necessary to have legal assistance.

With COBRA, the group health plan must have been covered by it; there must have been a qualifying event; and the person must be a qualified beneficiary. For an employee to be eligible for COBRA, he or she must have been employed at a private sector job or a state or local government job that sponsored the plan. There must have been a minimum of 20 employees for more than half of the business's typical days of work. All employees - full and part-time - are counted in determining if COBRA is applicable.

With qualifying events, it must have caused the person to lose the group health coverage. Qualifying events include the following: the employee being terminated for any reason other than gross misconduct; or the number of hours of employment being reduced. The spouse and a dependent child can also be covered under COBRA in the following situations: the termination of employment for any reason except gross misconduct; the reduction of work hours; the employee can get Medicare; there is a divorce or legal separation; or the covered employee dies. A child can also be covered if the child loses status based on the rules of the plan. They can then stay on the parent's coverage until age 26.

Since health care can be so expensive, COBRA can be a vital lifeline to people who have lost their job and need medical coverage for themselves and their loved ones in the interim. It must be paid for, but that is often a secondary consideration for those who are more concerned about having health coverage. If there is a problem getting COBRA for the eligible worker and dependents, a law firm that has experience helping unions get their benefits including COBRA can be of assistance.

Source: dol.gov, "FAQs on COBRA Continuation Health Coverage Q5: Who is entitled to continuation coverage under COBRA?," accessed on April 3, 2018

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