How does COBRA work in Texas?

Asked by: Gretchen Carter  |  Last update: August 18, 2023
Score: 4.2/5 (32 votes)

What is COBRA? COBRA stands for Consolidated Omnibus Budget Reconciliation Act of 1985. It allows you and/or your dependents to continue the health and optional insurance coverage (dental and vision) you have through the Texas Employees Group Benefits Program (GBP) for a specified period after you leave employment.

How does COBRA work when you leave a job?

COBRA coverage lets you pay to stay on your job-based health insurance for a limited time after your job ends (usually 18 months). You usually pay the full premium yourself, plus a small administrative fee. Contact your employer to learn about your COBRA options.

Does COBRA take effect immediately?

How long does it take for COBRA to kick in? With all paperwork properly submitted, your COBRA coverage should begin on the first day of your qualifying event (for example, the first day you are no longer with your employer), ensuring no gaps in your coverage.

What are COBRA rights in Texas?

Under COBRA, you and your family have the right to remain on whatever health plan your former employer has for up to 18 months. You must continue paying the full premium, which includes both your former employer's share and your share plus a 2 percent administrative fee.

Can I get COBRA if I quit in Texas?

You can get COBRA coverage if: You leave your job for any reason other than gross misconduct. Gross misconduct usually means doing something harmful to others, reckless, or illegal.

Everything you Need to Know about COBRA Insurance

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How long does COBRA last after I quit my job?

18 Months. Regardless if you quit, get fired, were layed off or retire you have the right to continue the employer's group health insurance for up to 18 months. You will coordinate this benefit with the human resources department of the employer or their third-party administrator.

How does COBRA work after termination?

(California passed a similar law known as “Cal-COBRA.”) Under COBRA, the group plan health insurance plan made available to terminated workers provides the exact same benefits as they would receive if they were still a member of the group, except that the employees have to pay the employer's cost of providing the ...

How long does COBRA last Texas?

The initial 18-month period of COBRA coverage may be extended up to 36 months for your dependents in the event of death, divorce or the loss of status as a dependent child during their initial COBRA eligibility period. For these situations, COBRA coverage cannot be continued beyond 36 months.

Are you automatically covered by COBRA?

To be eligible for COBRA coverage, you must have been enrolled in your employer's health plan when you worked and the health plan must continue to be in effect for active employees.

Is COBRA available if you are fired?

The Consolidated Omnibus Budget Reconciliation Act, known as COBRA, is a federal law that allows employees to continue their employer-provided health insurance after they are laid off or fired, or they otherwise become ineligible for benefits (for example, because they quit or their hours are reduced below the ...

When can COBRA be denied?

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.

When should I expect COBRA paperwork?

Your employer must mail you the COBRA information and forms within 14 days after receiving notification of the qualifying event.

What is the waiting start date for COBRA?

When does COBRA continuation coverage start. COBRA is always effective the day after your active coverage ends. For most, active coverage terminates at the end of a month and COBRA is effective on the first day of the next month.

Is COBRA a good idea?

COBRA can help bridge the health insurance gap until you qualify for another health plan. You have up to 60 days to accept if you don't sign up for COBRA right away. Coverage is retroactive. You can keep using the same claims filing methods, doctors, and pharmacists that you're used to.

Is COBRA retroactive after leaving a job?

Keep in mind that if you wait to enroll, you won't save any money. COBRA is always retroactive to the day after your employer coverage ends. So, you'll need to pay your premiums for that period too.

How do I calculate my COBRA payment?

If you want to figure this out on your own, ask HR how much your employer is contributing toward your monthly coverage. Then, check your pay stub to see how much you're contributing. After adding these figures, add another 2% (for the service fee). This will show you exactly how much you'll expect to pay for COBRA.

Does COBRA cost more than regular insurance?

You should expect COBRA insurance costs to be substantially higher than what you paid as an employee because your employer is no longer required to pay a share. In 2022, employees paid an average of $111 per month for an individual plan and $509 per month for a family plan, according to KFF.

How can I avoid paying COBRA?

If you want to avoid paying the COBRA cost, go with a short-term plan if you're waiting for approval on another health plan. Choose a Marketplace or independent plan for broader coverage. Choose a high-deductible plan to keep your costs low.

What triggers COBRA coverage?

COBRA Qualifying Event Notice

The employer must notify the plan if the qualifying event is: Termination or reduction in hours of employment of the covered employee, • Death of the covered employee, • Covered employee becoming entitled to Medicare, or • Employer bankruptcy.

Does Texas have mini COBRA?

Texas' Mini-COBRA Law

This law allows eligible individuals to maintain their health insurance coverage for a certain period after their employment has ended, even if they are no longer eligible for COBRA.

Can you stop COBRA at any time?

A person who elects COBRA can choose to cancel the coverage at any time (unlike active employee coverage, which can only be dropped during the employer's open enrollment period or during a special enrollment period linked to a qualifying life event).

How many months of COBRA do I need for retirement?

Under COBRA, a retired employee can receive the same health insurance coverage for up to 18 months. But you must pay the entire premium - part of which your employer probably previously covered. In some cases, people who opt to use COBRA also have to pay an extra 2% to cover administrative fees associated with it.

Is COBRA cheaper than marketplace?

Benefits of Getting Coverage Through The Healthcare Insurance Marketplace (HIM) In general, COBRA tends to be more expensive than HIM plans. Even though you are eligible to receive the same insurance that you had through your employer, you are now responsible for paying the entire premium cost.

What happens if you don't pay COBRA?

COBRA allows a 30-day grace period. If your premium payment is not received within the 30-day grace period, your coverage will automatically be terminated without advance warning. You will receive a termination letter at that time to notify you of a lapse in your coverage due to non-payment of premiums.

Can I cancel COBRA and get a refund?

Generally, there are no refunds when you cancel your plan early. You may contact your administrator or your past employer for specific insurance payment information.