Questions you might have about COBRA

No matter how your life changes, it’s important your health benefits remain the same. We’ll make it easy to continue your medical benefits for the immediate future. Below, you’ll find clear and straightforward answers to some of the most frequently asked COBRA questions. Don’t see yours listed here? Don’t worry, just email us.

I want to enroll in COBRA, what do I need to do?

Sign and date the Health Benefits Continuation Plan Enrollment Form, noting any changes to your information, such as a benefit drop or coverage level change. Return the form to Sentinel Benefits & Financial Group, along with a check made payable to your former employer, before the “Last Enrollment Date” stated in the cover letter, and on the Premium Computation Form. An envelope is included in the enrollment package for your convenience. Keep in mind that although you will have 45 days from the date the enrollment form is received to make your first payment, you cannot be reinstated onto the plan until the first payment is received.

How long does it take to be reinstated onto the plan?

From the date your payment is received at Sentinel Benefits & Financial Group, it generally takes five to eight business days for the insurance company to reinstate your coverage. Once coverage is reinstated, your coverage will be retroactive to the date you originally lost coverage. If you have incurred expenses during your enrollment period, call the phone number on your insurance card for reimbursement information.

How long can I be insured through COBRA?

It depends on the reason why you became eligible for COBRA: Your rights to continue health coverage through COBRA will continue for a set period of time after which coverage will generally terminate. The length of time will vary depending on the Qualifying Event that made you eligible for COBRA:

The following Qualifying Events provide an 18 month continuation right:
  • Voluntary/Involuntary Termination
  • Reduction of Hours
The following Qualifying Events provide a 36 month continuation right for family members who are Qualified Beneficiaries:
  • Death of the employee
  • Employee’s Medicare Entitlement
  • Divorce or legal separation
  • Dependent child ceases to be a dependent

Are there times when COBRA can be continued beyond the original term?

Yes. In certain instances COBRA coverage can be extended for an additional 18 months beyond the initial coverage period. This can happen when a second qualifying event occurs during the initial 18 month COBRA period and loss of insurance coverage otherwise would result.

Secondary events can include the following:
  • Termination or reduction of hours
  • Death of an employee
  • Employee’s Medicare Entitlement
  • Divorce or legal separation
  • Dependent child ceases to be dependent
The employee must notify the employer of the following secondary events: Divorce or legal separation or when a dependent child ceases to be a dependent within 60 days from the later of the secondary event or the resulting loss of coverage.

Under HIPAA, COBRA coverage may also be extended an additional 11 months (for a total of 29 months from the qualifying event) if any qualified beneficiary is determined by Social Security Administration to be disabled under the Social Security Act at any time during the first sixty days of COBRA coverage. The 11 month extension is available to all individuals who were qualified beneficiaries due to the qualifying event. During this extension the employer may charge up to 150% of the current premium for active employees, for continuation coverage.

The disabled individual can be a covered employee or any other qualified beneficiary. However, to be eligible for the 11 month extension, the affected individuals must notify the plan administrator within 60 days of the determination and before the end of the original 18 month period.

It is a qualified beneficiary's responsibility to notify the employer within 60 days of the disability determination and within 30 days of a determination notice that the person is no longer disabled.

When are COBRA premiums due?

Payments are due on the first of every month—but you are granted a 30-day grace period. As a result, your payments must be postmarked by the last day of the month in which they are due in order to be accepted. Payments postmarked after the grace period will be returned and your coverage will be cancelled. Once coverage is cancelled, it may not be reinstated.

I received the COBRA enrollment notification but I’m not sure how much I owe.

If your COBRA start date occurs on a date other than the first of the month, your first month’s COBRA premium will be prorated. This prorated amount will appear as the first payment on your Premium Computation form. The Health Benefits Continuation Plan Enrollment Form will provide you with a breakdown of each benefit’s monthly premium, as well as the Total Monthly Premium. While the monthly premium will remain the same after enrollment, the initial enrollment premium will differ based on the date payment is sent. Your enrollment payment must cover you from the COBRA qualifying event date through the end of the month in which you are sending the payment. The Premium Computation form provides premium totals and due dates throughout the 60-day grace period.

If part of your COBRA premiums are being paid by your past employer as part of a severance agreement, the initial payment due date on your Premium Computation Form will reflect this arrangement.

I don’t need COBRA to be retroactive to the date I lost coverage. Can I pay only for the months that I need coverage and/or from this point forward?

One of the main purposes of COBRA is to ensure that there are no gaps in coverage and to protect you against being denied future coverage based on a pre-existing condition. As a result, coverage must always be reinstated back to the COBRA Qualifying Event Date, regardless of whether you used the coverage during this time.

What happens if I miss a COBRA payment?

If you miss a payment your COBRA coverage will be canceled. There is a mandatory 30-day grace period built into COBRA law. This grace period is for your protection and allows payments due on the first of each month to be accepted as long as they are postmarked by the 31st of that month. Although you are offered the 30-day grace period and allowed to pay premiums at the end of the month, your prior employer is not extended this option. Your prior employer must pay the insurance company on the first of every month, regardless of when your payment comes in. If your 30-day grace period expires, your prior employer must inform the insurance company within a specific time frame in order to be credited for these premiums. Your prior employer must comply with COBRA law and puts itself in jeopardy if any exceptions are granted.

Does my whole family have to elect COBRA?

No, as long as the family members were covered under the plan, each person has independent election rights to COBRA.

I sent in my waiver form, can I still elect COBRA?

Yes, as long as you are within your COBRA election period.

When will my COBRA coverage end?

Your coverage through COBRA may end before the initial period, at the end of the initial period, or after the initial period depending on specific circumstances.

When coverage ends before the initial period:
  • If you fail to make scheduled premium payments within 30 days of when they are due.
  • If you become covered by another group health plan that does not include any exclusion or limitations with respect to pre-existing conditions.
  • If you become entitled to Medicare coverage.
  • If the employer ceases to sponsor all group health coverage.
  • If you are receiving an extension of COBRA because of a Social Security Disability, your COBRA coverage may terminate on the 1st day of the month 30 days after being deemed “no longer disabled” by Social Security Administration.
  • If you are determined to be ineligible for insurance coverage.
When COBRA coverage ends as expected:
  • Your COBRA terminates at the end of 18 months from employment termination and reduction in the number of work hours.
  • Your COBRA ends at the end of 29 months from employment termination or reduction in work hours coupled with a Social Security Disability Determination.
  • Your COBRA terminates at the end of 36 months in cases of employee death, divorce or legal separation, dependent ceasing to be dependent, and Medicare entitlement.
When COBRA ends after the initial period:
  • Your initial COBRA period may be extended if you experience a secondary qualifying event while you are covered through COBRA.
You may have certain conversion rights at the end of your COBRA term. Such conversion rights are specific to each group insurance contract and are only available subject to the terms of each policy.
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