DAVID F. BLAISDELL, Attorney at Law, 23020 Atlantic Circle Moreno Valley, CA 92553 Phone: 951-247-1977 WHAT ABOUT MY HEALTH INSURANCE BENEFITS AFTER THE MARRIAGE IS OVER? (INFORMATION ON COBRA BENEFITS) COBRA is an acronym for Consolidated Omnibus Budget Reconciliation Act. It is a federal law that was passed in 1986. This federal law generally just applies to employers with 20 or more employees. Cal-COBRA mentioned below is for smaller employers. COBRA provided that terminated employees or those who lose coverage because of reduced work hours may be able to buy group coverage for themselves and their families for a limited period of time. If the individual is entitled to COBRA benefits, the health plan must give notice stating the right to choose to continue benefits provided by the plan. There is a limited time to accept COBRA coverage. If it is not exercised in time the party will lose all rights to benefits. Once COBRA coverage is chosen the party may be required to pay for the coverage. In 1994 the time period was 60 days to accept COBRA coverage or lose all rights to benefits. COBRA contains provision giving certain former employees, retirees, spouses and dependent children the right to temporary continuation of health coverage at group rates. This coverage, however, is only available in specific instances. Group health coverage for COBRA participants is usually more expensive than health coverage for active employees, since usually the employer pays a part of the premium for active employees while COBRA participants generally pay the entire premium themselves. It is ordinarily less expensive, though, than individual health coverage. “Qualifying events” are certain types of events that would cause, except for COBRA continuation coverage, an individual to lose health coverage. Divorce or legal separation of the covered employee is one of the qualifying events. As of 1994 the ex-spouse has coverage of up to 36 months on COBRA. Plan administrators, upon notification of a qualifying event, must automatically provide a notice to employees and family members of their right to elect COBRA coverage. The notice must be provided in person or by first class mail within 14 days of receiving information that a qualifying event has occurred. Beneficiaries may be required to pay the entire premium for coverage. The premium cannot exceed 102 percent of the cost to the plan for similarly situation individuals who have not incurred a qualifying event. Premiums reflect the total costs of group health coverage, including both the portion paid by employees and any portion paid by the employer before the qualifying event, plus two percent for administrative costs. As the law stands now the person who wants COBRA coverage has 60 days from the date of entry of the final judgment to give written notification to the administrator of the insurance plan that the divorce or legal separation has occurred, and then you may be entitled to continued coverage. You, the person who wants the coverage, are responsible for notifying the insurance carrier. It does not happen automatically. You must notify the insurance carrier within the 60 day limit or lose your entitlement to these benefits. You should make a copy of the letter you send to the insurance carrier for your personal records. To summarize, there are two important functions which you must perform with regard to your continued COBRA benefits. First, you should confirm coverage under your spouse’s group plan just prior to entry of judgment. Second, you must notify the insurance company of the termination of your marital status (entry of judgment) within sixty days of the entry of such judgment. The information in this sheet on COBRA coverage may be out of date. You should call the health insurance plan you have know to find out more information. If further information on election or notification rights with a private sector plan write: United States Department of Labor, Pension and Welfare Benefits Administration, Los Angeles Area Office, 790 East Colorado Blvd., Suite 514, Pasadena, Cal. 91101. For further information you can also contact the Employee Benefits and Exempt Organizations Division, Office of Chief Counsel, Internal Revenue Service, 1111 Constitution Avenue N.W., Washington, DC 20224 (attention: CC:EBO, 5214). You can also call (202) 622-6000. CAL-COBRA California has instituted a COBRA like plan. It requires that health plans offer to continue the group coverage of employees and dependents of small employers with 2-19 eligible employees who would otherwise lose coverage because of a qualifying event. Under Cal-Cobra the notification process for continuation of benefits is up to the party to notify the health carrier. Further information on Cal-COBRA is at Health and Safety Code section 1366.20 and following and Insurance Code section 10128.50 and following. IF YOU KNOW OF ANYONE WITH ANY QUESTIONS ABOUT A FAMILY LAW MATTER PLEASE REFER THEM TO THIS OFFICE. THANK YOU! 1COBRA (cobra)
Posted on: Tue, 23 Sep 2014 00:00:50 +0000
Trending Topics
Recently Viewed Topics
© 2015