How to handle COBRA insurance issues and coverage delays

Losing your job is stressful enough without having to worry about losing your health insurance, too. That’s where COBRA coverage comes in — it allows you to keep the same health plan you had through your employer, even after you’ve left. 

But here’s the catch: COBRA is notoriously expensive. Since your former employer no longer covers any of the cost, you’re suddenly responsible for the entire premium, often hundreds or even thousands of dollars per month. And that’s not the only issue.

From confusing paperwork and missed deadlines to unexpected coverage lapses, COBRA can be tricky to navigate. Here are the most common COBRA problems people run into — and what you can do to fix them.

You don’t receive your COBRA paperwork or your notice is late

Your previous employer has up to 30 days from your last day of health insurance coverage to notify the provider of your COBRA eligibility. The insurer must notify you of your health insurance options when receiving this notice. After you receive your notice from the health insurance company, you have 60 days to enroll in COBRA. 

If your employer fails to notify the plan, you can contact the Department of Labor (DOL). The DOL fines companies that do not provide COBRA information within the proper time limits. You can also contact the benefits administrator at your previous company to ensure you receive the COBRA paperwork in time.

Alternatively, Brad Cummins, owner/principal agent at Insurance Geek, an online insurance broker, recommends contacting a COBRA administrator at the Department of Labor by phoning 866-444-3272.

You never receive your COBRA insurance enrollment packet

Sometimes, the COBRA enrollment packet never comes. Cummins points out that this can happen because of administrative errors or because your employer may not realize you are eligible for COBRA and are obligated to provide coverage.

“This can occur when employers — often smaller companies without in-house human resources personnel — neglect to provide the required COBRA information notice,” says Brian Martucci, finance editor at Money Crashers, an online publication dedicated to providing financial literacy for its readers. “If this happens to you, ask your HR point of contact to provide the enrollment packet.”

You paid your COBRA premiums, but the insurance company never received them

Here’s another possible snafu: Your COBRA premium is paid in full, but the insurance company claims they never got it.

In this case, you should immediately contact your previous employer and the Department of Labor (866-444-3272).

“This can be caused by banking errors, technical errors, and using the wrong information,” Cummins says. “You risk losing all your COBRA rights if your payments are not paid within the grace period, so do not delay.”

Also, keep a record of every payment you send, such as a check copy or bank statement, and “provide them to the insurance company if necessary to prove that you are not at fault for nonpayment,” Martucci says.

Your employer goes out of business or cancels your health insurance plan

Martucci says that if your former employer goes under, you and other COBRA-eligible employees will only be covered for as long as the employer’s health plan exists. 

Once COBRA insurance coverage lapses because of the employer’s nonpayment of premiums, you no longer have health insurance.

However, this doesn’t mean you won’t be able to get health insurance coverage — losing your group coverage is a qualifying event that starts a special enrollment period on the health insurance marketplace through the Affordable Care Act. 

“This gives you 60 days to enroll in an Obamacare marketplace plan, even if it’s outside the normal open enrollment. Others may choose to explore increasingly popular concierge or direct-care services on the private health insurance market,” says Mark Waterstraat, chief customer officer at Alegeus. 

You enrolled in COBRA and paid your premiums, but your doctor says you don’t have coverage

As if COBRA wasn’t challenging enough with its high costs and complications, it’s also possible your doctor may deny treating you and claim you don’t have coverage.

“This could be a network issue — your chosen provider isn’t actually in your plan’s network — or due to an issue with the plan itself, like if you sought care for a service not covered by the plan,” Martucci says. “On the other hand, this could arise because of some action or non-action taken by your employer, such as nonpayment of premiums or cancellation of the plan itself. Contact your plan administrator or insurer for more information.”

Your employer switched plans and you didn’t get the new health plan information

Rest assured that you can still receive insurance coverage if your employer abruptly switches health insurance plans.

If your employer has 20 or more employees and you qualify for COBRA, but they aren’t offering it, you can report the issue to the Department of Labor at 866-444-3272.

This is often an issue caused by poor human resources processes at your former company.

“Contact your HR representative to obtain the new health plan information. Your employer is required by law to provide it, and you are automatically covered under the new plan,” Martucci says.

Your COBRA premium increased substantially with no warning

Your insurer may raise COBRA premiums, or your employer may change your health plans after you leave, which could result in higher premiums.

“Unfortunately, this is a common occurrence in the world of group health coverage, and there is nothing COBRA recipients can do about it short of letting their coverage lapse and seeking a cheaper plan on the marketplace or private health insurance market,” says Martucci.

You switch jobs and your new health insurance doesn’t start for 90 days

The good news is that you have a new job. The bad news is that enrollment in your new company’s healthcare plan won’t be available for three or more months. What should you do?

“If you switch jobs, you can still stay on COBRA for up to 18 months as you wait for your new coverage to kick in,” says Cummins.

That can be expensive, however, and you may be better off bridging the gap with short-term health insurance coverage or a marketplace plan.

Short-term health insurance plans are significantly cheaper than regular health insurance plans and are a great alternative when you have a health insurance coverage gap.

Dealing with COBRA problems can be frustrating, especially when you’re already managing a life change like a job loss. But you’re not alone — and there are steps you can take to get coverage back on track. Whether it’s following up with HR, calling your insurer, or reaching out for outside help, acting quickly can make all the difference. And if COBRA isn’t working for you, there are other options that offer better coverage or lower costs. The key is to stay informed and keep asking questions until you find a solution that works.

Related Articles