What Are COBRA Benefits?
COBRA Benefits (continuation of coverage) are generally required to be offered/provided by employers with group health plans, and 20 or more employees in the prior year, following the life-events listed below.
Voluntary of Involuntary Job Loss
Reduction in Hours Worked - due to lost earnings or eligibility requirements
Dissolution of Marriage/Civil Union/Partnership
Employee Death
Eligibility for Medicare
Loss of Dependent Status
COBRA is actually an anacronym that stands for the Consolidated Omnibus Budget Reconciliation Act. It was a law passed by the US Legislature in 1985 and signed by President Reagan in 1986. COBRA outlines how employees and dependents may elect to enroll in the continuation coverage for group health plans provided by employers with 20 employees or more.
This law provides the right for eligible employees to temporarily extend the group health coverage their companies offer in certain instances where coverage would otherwise end. The COBRA Benefits recipient is responsible for the entire cost of the monthly premiums, as well as a 2% administration fee most typically. This is imposed by the company, not Premier COBRA (or the healthcare carrier). While many companies pay the majority of monthly premiums for employees, this does not occur for COBRA Benefits. The monthly cost will generally increases significantly compared to the employee premium rates.
It's a good idea to enroll in COBRA Benefits as soon as possible following the life-event listed above. This is not due to timing restrictions necessarily, but rather to ensure there are no issues if medical, prescriptions, dental, or vision care is required. The window to sign up for COBRA Benefits is ninety (90) days. And, please note, COBRA Benefits and the premiums will always start when the company benefits ended (regardless of when in the 90-day window COBRA Benefits are elected). There will never be a lapse in coverage unless premium payments or the 90-day enrollment window are missed. COBRA Benefits are available for 18 months following the life event.
Premier COBRA will contact eligible individuals as life event notifications come from the sponsor companies. Those instructions will guide participants to the Premier COBRA website where a passive member account was created based on the life event. Those individuals can then contact Premier COBRA via the website, phone, or email to activate the account.
Once the account is active, individuals can login in and enroll in COBRA Benefits. The process is a scaled-down and simplified version as follows:
Choose the medical, dental, and/or vision plans that are the best fit. Remember, this is a qualifying life event, so changes can be made from prior elections
Pay the first month's premium, or the premiums owed. For example, if an individual waits 45-days to enroll, two (2) months of premiums will be owed (COBRA Benefits always start when the employee coverage ended)
Premium payments are remitted to Premier COBRA and can be done so in a few different ways. Personal checks are accepted; payments can be made via debit or credit card on the website (processing fees may apply); and Premier COBRA also accepts PayPal, Venmo, and Zelle.
Member accounts within Premier COBRA will clearly show and detail all information regarding the life event, key dates and timing, who's enrolled, and high-level plan information. The benefits carrier (BCBS, Delta Dental, EyeMed, etc.) will continue to be the point of contact for questions or concerns regarding claims, bills, coverage levels, pre-approvals, and anything related to dealing with healthcare providers.
Nothing really changes in terms of using benefits under the COBRA status. COBRA Benefits are a continuation of benefits, so there is no change to the process for how individuals use them. Not only do the plan designs and process not change, individuals continue along their annual cycle in terms of meeting deductibles and other plan features (unless a change in election is made). The in-network and out-of-network providers and rates remain the same, which heavily reduces any concern about finding new doctors or providers. The major changes are the monthly costs and partnering with Premier COBRA to remit the premiums and receive updates/information regarding COBRA Benefits.