COBRA

What is COBRA?

COBRA is the continuation of group health benefits when a person leaves their job. All employers that offer group health insurance and have 20 or more employees must offer COBRA. Employees and their dependents are eligible for COBRA. Dependents may also be eligible for COBRA if they are receiving health insurance through a spouse or partner, and the working individual passes away or the couple divorces.

COBRA is time sensitive.

  • You must elect COBRA within 60 days of receiving the election forms. You should get these forms from your Human Resources and/or Benefits Department.
  • Payment must be made within 45 days from the time you elect COBRA.
  • Until you have enrolled in COBRA and your premiums have been paid, you may have trouble accessing your medical care or prescriptions. Any insurance claims that are pending during this time can be resubmitted upon completion of COBRA enrollment and payment.

COBRA has many advantages.

  • COBRA is a continuation of group insurance, which is often less expensive and more comprehensive than most individual coverage on the market today.
  • You can stay with the same insurance plan that your employer offered, which means you will not need to change health care providers. However, please note that your employers can change insurance companies during open enrollment periods, and this will change your COBRA coverage as well.

Am I eligible for COBRA?

If your employer provided you with insurance when you were working, you could be eligible for COBRA. All employers that offer group health insurance and have 20 or more employees must offer COBRA. Some employers offer COBRA even if they have fewer than 20 employees.

Ask your HR department or benefits administrator if your company offers COBRA benefits. You should be eligible if you were terminated for anything other than grievous reasons.

In addition, if you had insurance through a working partner or spouse, and they leave or lose their job, or you get a divorce, or your partner or spouse passes away, you may be eligible for COBRA. Please contact the appropriate HR department to verify this.

Can Evergreen pay for my COBRA coverage?

Yes, Evergreen can pay for your medical COBRA premiums if the policy was in effect before January 1, 2014, if you are eligible to be an Evergreen client, and if the COBRA policy meets our cost-effective criteria.  Evergreen cannot pay for a COBRA plan that is not effective yet.  If you recently experienced loss of employment, this is considered a 'qualifying event' that will allow you to enroll immediately into a Health Benefit Exchange plan.  Evergreen will pay for this Qualified Health Plan instead of a COBRA.  Refer to the relevant webpages for more information on how to enroll in a Qualified Health Plan with Evergreen's premium assistance.

If you become eligible for insurance through other means, such as a new job, Evergreen will no longer be able to pay for your COBRA. To be eligible for payment through Evergreen, COBRA must be your only insurance.

For Evergreen to pay for your existing COBRA policy, please submit an application.  Evergreen will need the Summary of Benefits for the plan and a bill for your COBRA premium. 

How do I apply for COBRA?

  • Your former employer should give you the necessary paperwork when you leave your job or otherwise become eligible. Employers have 14 days to give you this paperwork. If you have not received these forms, please contact your Benefits or HR departments.
  • After you receive this paperwork, you have 60 days to fill out and return necessary forms. If you need help, please ask your case manager or an Evergreen Insurance Advocate to assist you. Make a copy of the completed enrollment paperwork to keep for your records.
  • Submit the original COBRA paperwork along with an EHIP application to Evergreen. If you are not a current EIP client, you will need to enroll in EIP. We will process your application and send a check to your COBRA administrator. Payment must be made within 45 days of returning your COBRA paperwork, so meeting deadlines is important.

Other important information about COBRA

  • COBRA usually lasts 18 months.
  • If you become eligible for disability through the Social Security Administration while on COBRA, your COBRA may be extended to 29 months. You must notify the COBRA administrator within 60 days of being approved for disability in order to get this extension.
  • If you are the dependant on the plan, your total COBRA coverage period can last up to 36 months.
  • Should you become eligible for Medicare at any time during your COBRA election period, you may lose your COBRA eligibility.

A more detailed explanation of COBRA can be found at the US Department of Labor website.