When you leave a job or no longer qualify for benefits with your employer, the Consolidated Omnibus Budget Reconciliation Act, or COBRA, allows you to continue healthcare coverage in the group health plan. COBRA coverage is mandated by the federal government, but each state's department of health oversees the benefits. If a problem arises while you are covered by a COBRA plan or if you have an issue accessing your coverage, contact your health plan, the state office and the Department of Labor to lodge a complaint.
COBRA coverage is offered through the health plan you used at work. Start all complaints with the health plan but escalate more serious grievances to the Department of Labor and your state's health department.
When you first sign up for health insurance or a new plan with your employer, notifications regarding COBRA should be mailed to you. If you lose your job or have your hours reduced and no longer qualify for health insurance, your employer must notify the plan within 30 days. Should divorce or separation mean that you no longer qualify on a spouse's plan, you need to notify the plan administrator within 60 days. After the notification, the plan administrator mails a COBRA packet. Contact the health plan provider if you do not receive this packet in a timely fashion. The plan administrators have only 14 days to inform you of your right to coverage and how to enroll after the notification.
COBRA plans can be terminated if premiums are not paid in a timely fashion. Monitor your plan to make sure your payments are credited. Contact the plan administrator when you notice a problem and consider filing a complaint with the U.S. Department of Labor at 1-866-444-3272 if the situation persists or repeats every month. When possible, make your monthly payments with a debit or credit card to generate a payment confirmation number and log an instant receipt with your card issuer.
If you feel you are being denied coverage for a health event due to your status as a COBRA enrollee, contact your state's department of health and the Department of Labor to file a complaint. At the same time, continue to appeal the decision based on the health plan's guidelines. Refer to your plan materials to ensure you meet all necessary deadlines and obtain the required paperwork from your healthcare providers.
Plan Cancellations or Affordability Issues
COBRA coverage requires you to pay the health plan premium you paid as an employee, as well as your employer's portion. Cost hikes will happen when rates increase across the plan. If your plan is too expensive or is cancelled due to an employer no longer offering coverage, you may qualify for a special Affordable Care Act enrollment period. When you face a qualifying life event, such as the loss of a job, research ACA marketplace plans to see if they are more affordable than a COBRA plan. However, you must check before enrolling. If you opt for a COBRA plan, you can't enroll in the ACA again until the next open enrollment period.