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What is COBRA?
According to the Department of Labor Web site (http://www.dol.gov/dol/topic/health-plans/cobra.htm), 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, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost to the plan.
COBRA generally requires that group health plans sponsored by employers with 20 or more employees in the prior year offer employees and their families the opportunity for a temporary extension of health coverage (called continuation coverage) in certain instances where coverage under the plan would otherwise end.
COBRA outlines how employees and family members may elect continuation coverage. It also requires employers and plans to provide notice.
How long is a person covered under COBRA?
Depending on the circumstances of the qualifying event, coverage is 18, 29, or 36 months. Employees should ask their benefits administrator.
How do people make COBRA payments and to whom do they send the payments?
Payments are made on a monthly basis. Depending on who administers COBRA, payments will be sent to the administrator. The benefits administrator will be able to guide employees as to who collects the premiums.
If a person is on Medicare or becomes eligible for Medicare, is he/she still entitled to COBRA coverage?
If the person qualifies for Medicare prior to becoming effective for COBRA, the person is entitled to COBRA coverage.
If a person with existing COBRA coverage becomes eligible for Medicare during this time, the COBRA coverage ends.
If a subscriber passes away, how long are the person's spouse and his/her children covered?
If a person passes away while on COBRA, the remaining dependents on the policy are covered for a total of 36 months from the member's original effective date.
If a member was an active employee
at the time of death, the remaining dependents are covered for a total of 36 months from the employee's date of death.
When an employee's children reach the maximum age under the plan, how do the children switch to COBRA?
The employee must notify his/her benefits department, who will provide the necessary paperwork to enroll dependents.
Where should people get the application for COBRA?
All paperwork pertaining to COBRA must come from the employer.
Where do people get the rates for COBRA?
If Delta Dental Plan of New Jersey is administering COBRA, the rates may be obtained from the Delta Dental COBRA Department, at (973) 285-4145. If the group is administering COBRA, rates may be obtained from the employer.
Can people be covered under COBRA and a second plan at the same time, and can they coordinate benefits?
Yes, only if a second plan was in effect prior to the qualifying event for COBRA.
What happens if a person returns to work while on COBRA and receives benefits through the new employer?
Once someone becomes eligible for benefits through a new employer, the person is no longer eligible for COBRA coverage. If Delta Dental is administering COBRA, the notification must be sent in writing to: COBRA Department, Delta Dental Plan of New Jersey, P.O. Box 219, Parsippany, NJ 07054.
Do a person's benefits start over when going on COBRA?
No. COBRA is a continuation of existing coverage.
Maximums, deductibles and tooth history carry over.
Benefits remain the same.
If a person becomes disabled during the COBRA coverage period of 18 months, is the coverage period extended?
Yes. Disabled individuals are entitled to a total of 29 months of coverage. A member must provide the COBRA administrator with the proper documentation from a doctor.
When a person enrolls in COBRA, will he or she need an identification card to give to the dentist?
No. When a member goes to the dentist, the member should provide his/her Social Security number and COBRA policy number.
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