Can you be denied COBRA coverage?
Asked by: Mohammad Okuneva | Last update: October 23, 2025Score: 4.5/5 (42 votes)
What disqualifies an employee for COBRA?
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 rules for COBRA coverage?
- Your group health plan must be covered by COBRA.
- A qualifying event must occur.
- You must be a qualified beneficiary for that event.
My Employer Did Not Give Me My COBRA Continuation Health Coverage - What Do I Do?
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.
How much does COBRA cost per month?
The average monthly cost of COBRA Insurance premiums ranges from $400 to $700 per individual.
Can I be denied COBRA?
If the former employee is considered an eligible plan participant, then he or she would be a qualified beneficiary and entitled to COBRA coverage unless the second exception (denial based on gross misconduct) is applied. Under COBRA, a person who has been terminated for gross misconduct may be denied COBRA.
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.
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.
Does insurance end the day you quit?
When you leave or are let go from a job, your health insurance either expires on your last day of work or at the end of the month of your exit, says Andy Gillin, attorney and managing partner at GJEL Accident Attorneys. For example, if you quit on July 15th, your coverage usually continues until July 31st.
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.
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.
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.
Am I eligible for a COBRA if I am fired?
When the qualifying event is the covered employee's termination of employment or reduction in hours of employment, qualified beneficiaries are entitled to 18 months of continuation coverage.
What is a COBRA violation?
Employers have numerous responsibilities under COBRA, including tracking employee notices and deadlines. All too often, employers fail to comply with these requirements. Some common COBRA violations include: Failure to supply initial notice to new employees. Failure to provide notice after a qualifying event.
How to determine COBRA eligibility?
You must meet three basic requirements to be entitled to elect COBRA continuation coverage: Your group health plan must be covered by COBRA; • A qualifying event must occur; and • You must be a qualified beneficiary for that event.
What is considered gross misconduct?
Gross misconduct occurs when an employee engages in seriously inappropriate behavior at work, potentially warranting immediate termination. This behavior, which substantially breaches the company's standards of conduct, may include theft, fraud, violence, harassment, or severe insubordination.
What happens if a company doesn't offer COBRA?
Failure to provide the COBRA election notice within this time period can subject employers to a penalty of up to $110 per day, at the discretion of the court, as well as the cost of medical expenses incurred by the qualified beneficiary. Background.
Why is COBRA so expensive?
COBRA coverage is not cheap.
Why? Because you're now responsible for paying your portion of your health insurance: The cost your employer contributed to your premium, in addition to the 2% service fee on the cost of your insurance.
What are the disadvantages of COBRA coverage?
- COBRA can be expensive, especially compared to the premiums you were paying before your qualifying event. ...
- COBRA does not apply to all employer-sponsored health plans—in particular, those organizations with fewer than 20 employees may have no requirements. ...
- Even if you get an extension, COBRA is only temporary.
Does COBRA coverage begin immediately?
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.
Is COBRA cheaper than marketplace?
Both COBRA and ACA Marketplace plans have their advantages. COBRA lets you keep your exact employer-based plan but is often more expensive. ACA plans may be more affordable, especially with subsidies, but require choosing a new plan. The best choice depends on your financial situation and healthcare needs.