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COBRA for Terminated Employees

By , About.com Guide

Definition:

COBRA, refers to the Consolidated Budget Reconciliation Act of 1985, and specifically to Title X of the Act. The provisions of Title X include provisions to provide members of company health plans who have lost their coverage due to a "qualifying event" to continue coverage at the employee's expense for a period of time.

The law states that if an employer wishes to take a tax deduction for health insurance costs, the employer must provide employees who have been covered by the plan the right to continue coverage at the employee's cost (at the group rate) for a period of time.

COBRA Eligibility
To qualify for COBRA benefits:

  • The employee must be employed by an employer who has 20 or more employees (part-time employees are considered at a percentage of full-time).
  • The employee must have quit voluntarily or have been involuntarily terminated for reasons other than gross misconduct, or had hours reduced so as to no longer qualify for health coverage

  • A spouse may be eligible for coverage under the same circumstances as the employee (above), or if the employee is eligible for Medicare, or if the spouse and employee are divorced or legally separated, or upon the death of the employee.

  • A dependent child may be eligible for coverage under the same circumstances as the spouse and also if the child loses dependent status under the employer's plan rules.

Employer Responsibilities

  • Employers must assure that the COBRA coverage provided to eligible recipients is identical to the health plan coverage of similar current employees; if employee benefits change, COBRA coverage changes.
  • Employers are required to notify employees of their right to coverage when they terminate or some other qualifying event occurs.
Also Known As: COBRA benefits
Examples:
Sam was laid off by Smith Electronics, and he was eligible to purchase COBRA coverage to keep his health insurance benefits while he looked for another job.

Ellen was Julio's spouse, and she became eligible for COBRA coverage when he died.

Susan, Anna's daughter, became eligible for COBRA coverage when she turned 25 and was no longer eligible as a dependent under Anna's employee health coverage.

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