Can I be denied COBRA benefits?
Asked by: Mafalda Windler | Last update: October 23, 2025Score: 4.8/5 (28 votes)
Who is not eligible for COBRA coverage?
Why would an employee not qualify to enroll in Cal-COBRA? The employee is enrolled in or eligible for Medicare. The employee does not enroll within 60 days of receiving the notice of eligibility from the employer. The employee is covered by another health plan.
What is the COBRA loophole?
If you decide to enroll in COBRA health insurance, your coverage will be retroactive, meaning it will apply to any medical bills incurred during the 60-day decision period. This loophole can save you money by avoiding premium payments unless you actually need care during this time.
What if my employer didn't offer me COBRA?
Penalties for COBRA Violations
If an employer fails to provide the required notice and a lawsuit results, the employer can also be required to pay the attorney's fees of the former employee's lawyer and other damages. If you have been unlawfully denied COBRA benefits, let us know. We can help.
What are the qualifying reasons for COBRA?
In general, the COBRA qualifying event must be a termination of employment or a reduction of the covered employee's employment hours. Second, the covered employee must be determined under title II or title XVI of the Social Security Act to be disabled.
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Can my employer deny me COBRA?
Under COBRA, a person who has been terminated for gross misconduct may be denied COBRA. Gross misconduct is not specifically defined by COBRA, but when based on an employer's practice or policy it could include misrepresentation during the hiring process or falsifying information on a Form I-9.
Am I eligible for a COBRA if I quit?
Whether you quit, get fired or are laid off, you may be able to choose your former employer's health plan under a federal law called COBRA. That stands for Consolidated Omnibus Reconciliation Act. It's available if: You were enrolled in an employer-sponsored medical, dental or vision plan.
Can I sue my employer for not offering COBRA?
The employees along with the beneficiaries have the right to sue to cover the medical expenses that would have taken place when the COBRA should have been offered.
How long does your employer have to offer you a COBRA?
Your employer must mail you the COBRA information and forms within 14 days after receiving notification of the qualifying event. You are responsible for making sure your COBRA coverage goes into and stays in effect - if you do not ask for COBRA coverage before the deadline, you may lose your right to COBRA coverage.
Is COBRA coverage worth it?
“If you're close to meeting your deductible on your current insurance plan and you have high health care costs, it may be worth it to temporarily stay on your COBRA plan,” explains Donovan. The same holds true if you're far into your employer plan's year and have already met your deductible.
How much does COBRA typically cost per month?
COBRA coverage is not cheap.
A COBRA premium can cost on average $400 to $700 a month per person.
Can I decline COBRA?
Decide not to participate in COBRA and apply for special enrollment through Covered California. Because you will be newly uninsured, you will qualify for special enrollment in a Covered California health insurance plan outside of the annual open-enrollment period.
What is the 105 day COBRA loophole?
So, if you maxed out the 60 day election period plus the 45 day payment period, you could actually go 105 days without paying for the coverage.
What employers are not subject to COBRA?
The law does not apply to plans sponsored by the Federal Government or by churches and certain church-related organizations. In addition, many states have laws similar to COBRA, including those that apply to health insurers of employers with less than 20 employees (sometimes called mini-COBRA).
How do you determine COBRA eligibility?
COBRA eligibility has three basic requirements that must be met for you to get a continuation of coverage: Your group health plan must be covered by COBRA. A qualifying event must occur. You must be a qualified beneficiary for that event.
Can I go to the doctor while waiting for a COBRA?
You will be reimbursed for any medical bills that you pay out-of-pocket during this period. Contact the plan administrator for more information on filing a claim for benefits. Complete plan rules are available from the employer's benefits offices.
How long after termination can you apply for COBRA?
You have 60 days to enroll in COBRA once your employer-sponsored benefits end. Even if your enrollment is delayed, you will be covered by COBRA starting the day your prior coverage ended.
Who pays for COBRA coverage?
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.
What is the penalty for not offering COBRA?
Penalties for Non-Compliance
Failing to adhere to COBRA rules can result in costly penalties. The Department of Labor may impose fines of $110 per day per qualified beneficiary for non-compliance with notice requirements, and the IRS can levy excise taxes for violations.
Does COBRA coverage begin immediately?
Does the continuation coverage start from July 14 or from August 1st? The continuation of health insurance under COBRA starts the same day that the group health plan had ended after the premium payment has been made.
Can I sue my employer for not providing health insurance?
It has an obligation to honor that commitment, even though the law does not require it to provide health insurance. Otherwise, an employee can sue the employer to enforce the contract.
What happens if you never pay COBRA?
If you fail to make any payment before the end of the initial 45-day period, the plan can terminate your COBRA rights.
How long does a COBRA take to process?
Coverage under COBRA will be retroactive from your last day of coverage as an active benefits participant. This reinstatement normally takes between 5 and 10 business days from when your first full month of COBRA payment is processed.
What is considered gross misconduct for a COBRA?
Fighting, physical assault, abuse, or threatening behavior • Blatant disregard for the safety of others or serious breaches of health and safety rules • Deliberate acts of vandalism or sabotage • Any attempts to financially defraud the company or theft • Significant levels of insubordination • Dishonesty, falsification ...
Does health insurance end the day you quit?
When does health insurance expire after leaving a job in California? Your health insurance may expire the day you leave your job, or at the end of that month. For instance, if you quit on January 10th, you may have coverage through January 31st. You'll need to find out what your employer's policy is.