What are the qualifying reasons for COBRA?
Asked by: Zula Jacobson | Last update: June 21, 2025Score: 4.2/5 (27 votes)
What are the 7 COBRA qualifying events?
The seven COBRA qualifying events that allow individuals to maintain their employer-sponsored health insurance include termination of employment for reasons other than gross misconduct, reduction in the number of work hours, divorce or legal separation from the covered employee, the covered employee becoming entitled ...
What makes you eligible for COBRA?
COBRA coverage follows a "qualifying event". An example of a qualifying event would be if your hours were reduced or you lost your job (as long as there was no gross misconduct). Your employer must mail you the COBRA information and forms within 14 days after receiving notification of the qualifying event.
Under what circumstances can a COBRA be denied?
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.
Which of the following is not a qualifying event for COBRA?
Coverage provided under the FMLA is not COBRA coverage, and taking FMLA leave is not a qualifying event under COBRA.
COBRA Qualifying Events
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.
Who is not covered under COBRA?
You do not have to offer COBRA coverage to any of the following: an employee who is not yet eligible for your group health plan. an eligible employee who declined to participate in your group health plan. an individual who is enrolled for benefits under Medicare.
Can I get a COBRA if I quit my job?
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.
What employers must have to be eligible for COBRA?
The extension period is 18 months and some people with special qualifying events may be eligible for a longer extension. To be eligible for COBRA, your group policy must be in force with 20 or more employees covered on more than 50 percent of its typical business days in the previous calendar year.
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.
How long does it take for a COBRA to kick in?
COBRA coverage timeline
The coverage starts the day the previous coverage ends. The employer's COBRA administrator is responsible for sending out an election notice with information about deadlines for enrollment. For example, if employment ends on April 25, COBRA will pick up where the group health plan ends.
Is it better to use COBRA or obamacare?
ACA plans may offer significant cost savings through subsidies that aren't available under COBRA. By transitioning to an ACA plan, you can often find more affordable coverage without waiting until COBRA expires, giving you flexibility in managing your healthcare costs.
How much does COBRA cost?
COBRA insurance typically costs 102% of the total health plan premium. This includes both the employee and employer contributions, along with a 2% administrative fee.
What determines 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.
What are examples of individuals who would qualify for COBRA?
A qualified beneficiary is an individual who is entitled to COBRA continuation coverage because he or she was covered by a group health plan on the day before a “qualifying event.” Depending on the circumstances, the following individuals may be qualified beneficiaries: a "covered employee" (a term that includes active ...
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 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.
Are COBRA payments tax deductible?
Are my COBRA premiums deductible? Yes they are tax deductible as a medical expense. There isn't necessarily a “COBRA Tax Deduction”. You can only deduct the amount of COBRA medical expenses on your federal income tax in excess of 7.5% of your Adjusted Gross Income and then only if you itemize deductions.
How long can you stay on COBRA?
While COBRA is temporary, in most circumstances, you can stay on COBRA for 18 to 36 months.
Is COBRA 18 months or 36 months?
COBRA insurance typically lasts 18 months for employees, up to 36 months for dependents, and can be extended to 29 months for those with a qualifying disability.
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.
What is the timeline for COBRA?
60 days: The COBRA-eligible participant(s) have 60 days to enroll in coverage. If the COBRA-eligible participant does not elect coverage within 60 days after the notification, they are no longer eligible to elect.
Which of the following would be a qualifying event as it relates to COBRA?
Final answer: Under COBRA, qualifying events are situations which result in a loss of health coverage. The options that qualify are termination of employment due to downsizing and voluntary resignation for personal reasons. Retirement and graduation from university are not considered qualifying events.
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.
Will I qualify for COBRA if I quit my job?
Yes, You Can Get COBRA Insurance After You Quit Your Job
To be eligible for COBRA, you need to have been a covered employee and must have had insurance coverage at the time of your employment termination.