What qualifies for a COBRA extension?
Asked by: Jacklyn Strosin | Last update: January 4, 2026Score: 4.7/5 (67 votes)
What are the reasons COBRA can be extended?
COBRA allows extended coverage for qualified beneficiaries who experience second qualifying events within the 18-month continuation period. Approval for Social Security disability (29 months). Death of the former employee. Divorce from former employee.
What are the qualifying events for COBRA continuation coverage?
- The employee is no longer employed for any reason other than gross misconduct.
- The employee's hours are cut.
- Covered employee becomes entitled to Medicare.
- You are no longer a dependent of the employee.
What is the 60 days COBRA loophole?
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.
Under what circumstances will the benefits under COBRA continuation coverage end?
Your COBRA continuation coverage will terminate before the end date of the maximum continuation period stated in the Specific Rights Notice if: The full premium is not paid on time. The qualified beneficiary becomes covered under another group health plan.
COBRA and Medicare
What is the COBRA coverage extension?
If you are entitled to an 18 month maximum period of continuation coverage, you may become eligible for an extension of the maximum time period in two circumstances. The first is when a qualified beneficiary is disabled; the second is when a second qualifying event occurs.
What are common exclusions to the continuation of group coverage?
Common exclusions to continuation of group coverage include: Dental Coverage, Other Prescription Drugs. How would a contingent beneficiary receive the policy proceeds in an Accidental Death and Dismemberment (AD&D) policy? If the Primary Beneficiary dies before the insured.
How to stay on COBRA for 36 months?
18 to 36-Month Period (Second Qualifying Event): A spouse and dependent children who already have COBRA coverage, and then experience a second qualifying event, may be entitled to a total of 36 months of COBRA coverage.
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.
Is there a grace period for COBRA payments?
After you are established on your COBRA coverage, ongoing monthly payments are due the first day of each month. There is a grace period of 30 days from the due date for ongoing monthly premium payments. If you mail your payment, it must be postmarked within the 30-day grace period.
Which of the following is not a qualifying event to trigger COBRA coverage?
Taking a leave of absence under the Family and Medical Leave Act of 1993 (FMLA) is not a COBRA qualifying event because FMLA requires a covered employer to maintain group health plan benefits for an employee so the employee has no coverage loss.
How long can you stay on COBRA after leaving a job?
You can stay on COBRA for 18 or 36 Months
However, dependents on the plan, such as a spouse or children, can be eligible for up to 36 months of coverage under certain circumstances, like divorce or the death of the covered employee.
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 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 is the COBRA disability extension?
In certain circumstances, if a disabled individual and non-disabled family members are qualified beneficiaries, they are eligible for up to an 11-month extension of COBRA continuation coverage, for a total of 29 months. The criteria for this 11-month disability extension is a complex area of COBRA law.
What happens when your COBRA runs out?
What do I do when my COBRA runs out? Since the Affordable Care Act, running out of COBRA continuation coverage is now a “qualifying life event,” which means that you now have a “special enrollment period” in which you may enroll in an insurance plan outside of open enrollment.
What is the maximum length that COBRA benefits may be extended?
You can collect COBRA benefits for up to 18 months. This may be extended to 36 months under certain circumstances. If your employer has 20 or more employees, it must follow COBRA rules. COBRA coverage follows a "qualifying event".
What is the loophole for COBRA coverage?
Understanding the 60-Day Loophole
It's not so much of a loophole, but two 60-day windows of time to remember. You have a 60-day window following the end of your employer-sponsored plan to select COBRA coverage or choose a new plan in the individual ACA marketplace.
How many times can you go on COBRA?
You May Only Use COBRA One Time For Each Qualifying Event That Stops Your Health Insurance. COBRA continuation lasts for up to 18 months (in some situations a dependent can continue for up to 36 months) and is available each time your employer-sponsored health insurance would end due to a qualifying event.
Is there any way to extend COBRA coverage?
Consumers may also extend COBRA continuation coverage longer than the initial 18-month period with a second qualifying event—e.g., divorce or legal separation, death of the covered employee, Medicare entitlement of the covered employee (in certain circumstances), or loss of dependent child status —up to an additional ...
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.
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.
Under which of the following circumstances will the benefits under COBRA continuation?
The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, ...
What is the ADA missing tooth clause?
As a rule, when it applies, any tooth missing or extracted prior to the current plan's effective date will not be covered. In other words, the patient must have had the same insurance carrier when the tooth was extracted. Certain plans do have special provisions allowing for coverage.
What is the illegal activity exclusion?
However, criminal defendants who are arrested but are ultimately acquitted may still pay the price even if they are not responsible for what occurred, and are injured or harmed as a result. The provision, known as the “illegal act exclusion,” provides that if an injury resulted from the commission of a felony.