Hi All,

I posted this info in another thread about a day ago and haven't heard a response from anyone. The thread was a week or two old and figured it might have run it's course. I may be going over an issue most of you all are informed on, but it was something that I had absolutely no info about. But when I got laid off due to lack of work, I found out that Pres. Obama had put into effect a law that for the first 9 months, if you select to maintain COBRA, YOU only have to pay about 30% of the total premium and a gov. assistance program picks up the rest. Now this is only for the first 9 months, not forever. But that can give you or your spouse, (whoever is able to hold down a full time job & get insurance benefits) enough time to maybe find another job, go thru the wait period, yadda, yadda, yadda if they/you happen to get laid off and want to keep your insurance thru COBRA. This REALLY helps. They seem to not be letting people know about this very well, at least I sure didn't, I only found out about it because of the wonderful man that I dealt with through AETNA while setting up the COBRA. Otherwise I wouldn't have a clue. He had absolutely no obligation to mention this to me, but I thank the Lord above that he did. You have to fill out a little form saying you want this to take effect, no biggie at all. But if you still have the time frame to get COBRA, PLEASE check into it. Like I said they really kept this hush, hush to me but I am proof that it is there cause I'm on it. Instead of paying $1173 a month for my husband and I, we pay only $410. Just call whoever your past insurance rep. was and tell them you want the "COBRA Election Form" sent to you asap. Again this is a tough row to hoe, but every little bit helps and I hope this helps someone by getting the word out. By the way, the insurance was through HIS job, he got fired the same time I lost my job of all things for not calling personally because I had to go to the Emergency Room in an ambulance and he asked his mother to call work for him to notify them that he was not coming in because he had to go with me to the ER. (It was just a big fat excuse, they where looking for a way to fire him cause they had too many employees and this was an easy way out). He was never given a company rule book or told that this was not acceptable proceedure. Again, if this is already common knowledge among everyone I apologize, but I sure never heard of it. Just trying to pass along a little info for everyone.

Best wishes to all,
LeMans:)

That's great information....Thanks for posting.

How long can COBRA run after one leave an employer?

Ex

Executor,

Thanks for the reply. I went in and looked over my paperwork. From what I gathered, there are a number of different "qualifying events" as they put it, that can alter how long Cobra can remain in effect (as long as you can pay for it that is! Ha). But it looks like it can go up to a maximum of 36 months if you meet the max. qualifying event. (i.e. it's like the death of a parent or spouse or something similar that started up the Cobra process to say take care of a dependent if you had a family policy.) I would say for the typical case though, like me, it can go up to around 18-24 months. Luckily, my husband is starting a new job Monday and we just need to make it to when the new insurance kicks in. So we keep on paying for our Cobra with Aetna (and they are strick people, we've been on it with other insurance companies in the past and you CANNOT be late one time with your payment or that is it, they cut you off!)

Just get the name & number of whoever's in charge of the insurance dept. in your company's Human Resources Dept. and get the ball running as soon as you can.
Hope this info helps.

Best of luck to everyone,
LeMans

Ex,
With most policies, COBRA runs for 18 months, then you are SOL. It was designed to cover you as a stopgap until you started another job and got covreage again. They didn't think that folks could be out of work for years...

It is really important that you mentioned this. When my husband got layed off in 03 I had just started PM and my meds were very expensive. We had to do COBRA fortunately for only a month or two but with having to move, breaking even on our home as we had only been there 18 months, and finding a new home the 1200.00 a month was brutal. But with my meds we had no choice as one of them alone was 5000.00 a month. So this is HUGE for anyone who needs COBRA so thank you!

Melissa

As long as one could afford, or was willing to make the payments, I would think COBRA should be permitted to go indefinitely. One paying COBRA is paying the full cost of the insurance, so it shouldn't matter how long one stays on the policy. But, unfortunately, that's not the case.

Ex

My employer uses a very well known third party administrator for paying COBRA and I'll have to say they up front provided me information on the Premium Reduction (I won't qualify as while on STD or LTD they keep me as an employee so I don't meet the qualifying requirements of loosing coverage.....they just convert me to retiree coverage). And my husband just got laid off and his company did the same thing so he immediately knew he could pay less for 9 months. We were lucky.

Good for you SpineAZ. I'm glad to hear they were up front with you. And Executor you're absolutely right, you are paying those whopping full premiums after 9 months so why not let you stay on if you choose to and can afford to? Wish I had an answer for that one. I know! Maybe we could all magically wake up tomorrow morning with no more health problems and we wouldn't need insurance!

We can always dream on! LeMans

There is also a little known COBRA rule that I just found out. If you are awarded SSDI and not yet eligible for Medicare, you can extend your COBRA benefits. HOWEVER, you must notify them within the first 60 days that you received your award letter. Also, your premium will go up at least 150%.

I found this out through my own research and found out too late to request an extension, so they denied me. Now, I have a 6 month gap where COBRA ends and when Medicare kicks in. I'm in the middle of fighting them over it. I have talked to someone at the Dept. of Labor and he said there really is no need for the 60 day requirement because if you have COBRA now, it's nothing to just extend it. Also, if someone receives their award letter in their last month of COBRA, they would be allowed to extend it.

I'm going to be writing them a letter on Monday. I am looking into other alternatives. The problem is nobody wants to cover anyone with a chronic condition that requires several doctor visits, injections, prescriptions, etc. I can't take a high detuctable because I know I'm going to be needing injections and they cost from $3,000 to $5,000.

The problem is they say they sent that information to me. I say they didn't because I filed everything I have received from them and I don't have it. I asked them if I signed something saying that I received it and they said "no".
So, neither they nor I can prove that the information was or was not sent out.
I just felt like COBRA was being very sneaky on this topic.

Harplady

There is also a little known COBRA rule that I just found out. If you are awarded SSDI and not yet eligible for Medicare, you can extend your COBRA benefits. HOWEVER, you must notify them within the first 60 days that you received your award letter. Also, your premium will go up at least 150%.


This is very good information. So, what happens when a person has filed for SSDI, but has been either denied or in appeal? Can you extend COBRA while you appeal? As you know, very few are awarded SSDI initially and most have to appeal many times.

Ex

Here's how it works:

If the individual entitled to the COBRA continuation coverage is disabled (as determined under the Social Security Act) and notifies the COBRA administrator as required on a timely basis, the plan must provide COBRA continuation coverage for 29 months, rather than 18 months. The disability extension is provided if the individual becomes disabled at any time during the first 60 days of COBRA continuation coverage.

The 29 months bridges the gap until medicare is available. Anyone disabled must have a waiting period of 5 months before SSDI begins, then 24 months of SSDI benefits before medicare coverage begins, thus a total of 29 months.

Unfortunately, according to the US Dept of Labor there are no provisions in place for anyone who has not yet been approved for SSI or SSDI. So it means anyone who is eligible for SSDI would be well advised to apply as soon as they meet the 5 month waiting period. From what I've read (recently got COBRA information from my employer's thrid party administrator and did some research) if the individual is initially denied SSDI and appeals and is later approved, but the appeal and approval doesn't happen until COBRA ends, then the individual is not eligible for the extension.

I have heard that under the HIPAA rule that you have access to certain insurance plans if you have tried to get other insurance and have been denied or if you have exhuasted your COBRA benefits. Those who have not yet been awarded disability could fall into this catagory. The following website might be helpful:

http://www.dol.gov/dol/topic/health-plans/portability.htm

I also received an email from David Holstein from Dept. of Human Services - specifically he works at the center for Medicare & Medicaid Services. He referred me to the following website for information on extending COBRA benefits:

www.cms.hhs.gov/COBRAContinuationofCov/

Go to the left navagation bar, click on "Extended Periods of Coverage."

I hope this is helpful.

Harplady

if the individual is initially denied SSDI and appeals and is later approved, but the appeal and approval doesn't happen until COBRA ends, then the individual is not eligible for the extension.

So, if I understand you correctly SpineAZ, there is no provision for someone who is out of work and has applied for SSDI, been denied initially, and COBRA has ended.

For example, if someone goes out of work Jan 1, 2009 applies for SSDI on June 1 (5 full months), is denied sometime that Fall at the first stage, and of course, appeals. However, COBRA ends after 18 months (from Jan 1) at the end of June 2010. If the person isn't approved for SSDI before the end of June 2010, they can't extend COBRA for the 29 months. Is this correct? This is the way I understand things explained thus far. Just want to be sure I understand everything exactly for future reference.

As usual, thanks for your input.;)

Regards,

Ex

Yes, From my research and review of information on the Department of Labor site there are no stated provisions for anyone who has not been approved by SS as of the 18 month mark.

www.dol.gov and search COBRA disability extension

It would be interesting to know what an SS attorney says about this, unfortunately I don't know any (yet).

Yes, From my research and review of information on the Department of Labor site there are no stated provisions for anyone who has not been approved by SS as of the 18 month mark.

Thanks Spine! Seems to me that this is a big crack in the system.

Regards,

Ex

this happened to me.

they do not extend cobra during the wait for ssdi...

i was on cobra for 18 months and then i got denied ssdi and went into appeal stage for over 2 years so i was without medical coverage for 2 years. because i had no coverage, nobody would see me for pain except the emergency room. i found out after getting ssdi that they go back and cover those 2 years i did not have medical.

i was told by my local ssdi office that there is no way that i would be turned down for ssdi but in the last 48 hours of the expected letter arriving they changed their mind and i had to wait almost 3 years and all i got from the judge at the hearing was this should of never happened and i am very sorry that it did.

this is why i always tell anyone going for ssdi to get an attourny. the $5300 is well worth paying.

don't make the same mistake as i did,
sorry for ranting on,

mike



This is very good information. So, what happens when a person has filed for SSDI, but has been either denied or in appeal? Can you extend COBRA while you appeal? As you know, very few are awarded SSDI initially and most have to appeal many times.

Ex

My company laid me off and they have a 3rd party that handles the COBRA benefit. They had the regular COBRA rate listed and then the "subsidized rate" for the first 9 months. My subsidized rate is $130 and the regular rate was close to $400. I don't think that I could pay the full amount so i was grateful that the Obama administration put this rule into effect. I believe it is only for people that have lost their job from last fall through the end of this year. Don't quote me on that but I believe that is what the letter said. It was mean to help all of the people that lost their jobs during the recession/depression and I am grateful for it.

brian

I have my COBRA paperwork right here. This was called the American Recovery and Reinvestment Act (ARRA) and it reduces premiums for periods of coverage beginning on or after 2/17/08 and lasting up to 9 months. The individual must have become eligible for COBRA between 9/1/08 and 12/31/09.

It reduced my coverage from $450 to $182, so I am happy to have it, I just hope I find a job before the 9 months are up, or I won't be having insurance.

Cat

Keep in mind the ARRA only comes into play for INVOLUNTARY termination (not for resignation, retirement, etc)

An assistance eligible individual is the employee or a member of his/her family who is eligible for COBRA continuation coverage at any time between September 1, 2008 and December 31, 2009. The person must elect COBRA coverage and is eligible for COBRA as a result of the employee's involuntary termination between September 1, 2008 and December 31, 2009.

I mentioned previously that I am eligible for Medicare beginning June 1, 2010. However, my COBRA benefits end on December 1, 2009. I am trying to get coverage for 6 months. I got a denial letter today from AETNA - I had applied for an individual policy. Of course it was due to all my medical conditions and prescriptions I have to take.

My husband is a business owner with about 10 - 15 employees. If he adds me to his insurance, the rate his business has to pay more than doubles - were talking about many tens of thousands of dollars per year!

I had applied for this AETNA policy through AARP, at the bottom of the letter it says I may be eligible for coverage under HIPAA. These are usually high risk pools and are very expensive. But, it's my last choice. Paying the premiums are not the problem for us, my husband makes a good income. I would be willing to pay a higher premium - I just can't get anyone to cover me.

I have Hypermobility Syndrome, a genetic disorder. This is not something I brought upon myself due to poor health habits. I don't smoke or drink, I'm not overweight, I exercise daily, I eat healthy food, I go for all my wellness checkups. I'm really worried that if this high risk insurance doesn't work out that I'll have to be without insurance for a few months. Although, I can't complain too much there is a light at the end of the tunnel because I do have disability and will get medicare. I have greater empathy for those who do not see the end in sight. Something really needs to be done about this.

Harplady

Looks to me that you'd be eligible for COBRA extension since you've been granted SSDI. I've contacted SpineAz to see if she could help. This is her area.

Regards,

Ex

You'd be eligible for COBRA extension only if your approval for SSDI came before the end of your initial COBRA eligibility. But,if the dates were close I'd encourage you to go back to the COBRA administrator to see if they can help.

Is it possible for your husband to add you just until Medicare kicks in? I know it's expensive but if you were to become ill or injured it would cost more in the end. Even if you are only on pain management (with no surgeries or procedures planned) you never know when something unexpected can happen.

As I mentioned before, I was awarded SSDI within the first 60 days of receiving COBRA, However, I did not request the extention within 60 days after receiving the award letter. I was not aware that I could extend my benefits until just recently and I only found that out through my own research. By that time it had been 90 days since receiving the award letter, so they denied me.

I just received information on the HIPAA coverage and it looks like I have 2 plans I can choose from one is 2500 deductible at $710 a month and 5000 deductible and $950. I'm very fortunate that I have the means to pay these premiums, but , these amounts are outrageous. They say that HIPAA guarantees coverage for all - it looks like it's really coverage only for those who have the means.

I was paying about $400 a month for COBRA so if I was able to extend it, they would have raised my rate the 150%, so I would have been paying close to $600. My eyes have really been opened through this process.

Harplady

SpineAZ

We were trying to avoid putting me on my husband's insurance because he is the owner of his business. To cover all his employees his business would pay $45,000 a year. To add me on, the rate went up to $95,000 a year. It's illegal to raise rates due to the ill health of any of the subscribers, but the insurance gets around that law through a loophole. I think it's terrible that they can do that. So I think HIPAA is the way for me to go.

Harplady

I was awarded SSDI within the first 60 days of receiving COBRA, However, I did not request the extention within 60 days after receiving the award letter. I was not aware that I could extend my benefits until just recently and I only found that out through my own research. By that time it had been 90 days since receiving the award letter, so they denied me.

IMHO, our government leaders could go a long way to improving this nation's health care by closing loopholes, and improving some of the basics, with this being one of them. It's ridiculous that we have to be benefits experts in order to take advantage of the parts we need and deserve. The law should require carriers to spell out one's options so a person can make an informed decision.

I don't want to get too sidetracked here, but instead of completely overhauling our nation's healthcare, we need a major tune up....Walk before we run so to speak. There are all sorts of places where major improvements can be made that would go a long way towards improving our overall health care.

Another one is Medicare. They advertise the benefit that everyone gets to pick their own plan, but the problem is that because everyone is spread out on 50+ plans, most of them aren't very good. Want to improve health care for our nations retired and disabled? Either put them on the existing federal plan or even better, pool them all together and put the business out for bid like a big corporation does and use the overall size of the group to your advantage. Undoubtedly, the cost would be cheaper for all, plus the overall benefits would probably improve dramatically. This is how to "fix" health care....Not via radical changes. Insurance is set up to benefit the companies, not the policy holder.

Regards,

Ex

Well, now that we are all experts on this area of insurance law, I feel like we're ready to go to D.C. and help Obama make some of these changes. Judging by the length of this thread, there is a need for this information to get out to those who are most affected by it.

Thank for listening to me as I vented my way through this process.

Harplady