A fear of losing your job is often compounded by a fear of losing your health insurance. But there’s hope. You may be eligible for the continuation of your health insurance benefits through a federal law known as COBRA — short for the Consolidated Omnibus Budget Reconciliation Act.

health insuranceCOBRA provides a vital bridge between group health insurance plans for qualified workers, their spouses and their dependent children when their health insurance gets cut off. It's a safety net for families in the midst of crisis, such as unemployment, divorce or death of a spouse. 

COBRA lets you keep your health coverage for 18 months after your last day at work if your employer cuts your hours or you voluntarily leave your job or lose your job. The only exception is if you're fired because of gross misconduct. 

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COBRA generally requires that group health plans sponsored by employers with 20 or more employees offer workers and their families the opportunity to temporarily extend their health insurance coverage. The law grants an exemption to the District of Columbia, federal employees, certain church-related organizations and firms employing fewer than 20 people. Some states also expand COBRA for former employees of smaller companies. 

One negative about COBRA is the costs. You get to keep your health insurance temporarily, but you also have to pay all the costs. The employer will no longer help you. 

Here's what you need to know about COBRA: 

1. Certain "qualifying events" trigger 36 months of COBRA coverage for your dependents.

Voluntary or involuntary job loss (except in instances of gross misconduct) triggers 18 months of COBRA coverage for you and your dependents. Your spouse and dependent children are entitled to 36 months of continued coverage under certain circumstances:

  • You become eligible for Medicare.
  • You get divorced or legally separated.
  • You die.

Additionally, your dependent child is eligible for 36 months of continued coverage under COBRA when he or she loses dependent-child status on your health insurance plan.

2. Your former employer can cancel your COBRA coverage if it drops group health insurance coverage completely or goes out of business.

When an employer goes out of business or drops its employee health insurance altogether, COBRA law doesn't apply because there is no health plan to "continue."  Also, if the company reduces its employees under 20, you're no longer eligible to receive COBRA.

3. If you move outside your COBRA health plan's coverage area, you effectively "lose" your COBRA benefits.

Let's say you lose your job in New York and decide to seek new employment in Texas. You can still enroll in COBRA, but you may not be able to find local doctors on your plan. Many health insurance plans require that you use their local provider networks. Your employer isn't required to offer you a plan in your new area.

4. You must pay all of your health insurance premiums under COBRA.

Cost is a major factor to consider when buying COBRA coverage. By law, you can be charged 100% of the plan's premiums, plus up to a 2% administrative fee. Employers usually pay more than half of health insurance premiums. With COBRA, the former employee has to pay all the premiums. The average employer-sponsored family health plan costs more than $20,000, so COBRA can be expensive. Find out more about COBRA costs.

5. There are potentially more affordable alternatives to COBRA.

Until 2014, COBRA was the only avenue for most Americans to get health insurance after a layoff. Now, people have access to potentially affordable health insurance coverage through the Affordable Care Act marketplace or a short-term health plan. ACA plans also provide subsidies to lower middle class Americans. These subsidies help reduce the cost of the ACA plan. When looking for an ACA plan, your state's insurance exchange will take your household into account and provide premium estimates with subsidies in mind. 

6. If you're eligible for Social Security disability benefits, you may receive 29 months of COBRA coverage.

If the United States Social Security Administration (SSA) determines that you're disabled, you may be entitled to up to 29 months of COBRA if:

  • You experience an 18-month qualifying event for COBRA (voluntary or involuntary job loss).
  • SSA determines you were disabled either before the COBRA event or within the first 60 days of COBRA continuation coverage.
  • Your health plan administrator has a copy of your SSA disability determination within 60 days after the determination is issued and before the end of the initial 18 months of COBRA.

7. Many states have their own "mini-COBRA" laws that grant broader rights in determining COBRA eligibility.

Even if you work at a small company that is exempt from federal law, you might not be out of luck when it comes to COBRA. Many states have their own "mini-COBRA" laws that give workers at firms who have between two and 19 employees the right to continue their group health plans.

While COBRA applies to self-funded plans and group health plans offered by employers with 20 or more employees, mini-COBRA laws don't apply to self-funded plans.

8. Under COBRA, you have the same health insurance rights during "open enrollment" as your former employer's active employees.

If your former employer offers an open enrollment period to active employees and you're on COBRA, you (and your COBRA-enrolled spouse and dependent children) have the right to switch health insurance plans at that time. You may also add new dependents if your employer offers this option to active employees. Newborns can be added at any time during the year as long as they are added within 30 days of birth.

9. Because COBRA is a federal law, the U.S. Department of Labor has jurisdiction over COBRA grievances.

Contact the U.S. Department of Labor, the agency that administers COBRA, if you believe your employer is in violation of COBRA law. The toll-free telephone number is (866) 444-EBSA (3272). Or see COBRA information on the Employee Benefits Security Administration Web site.

10. Even if you enroll in COBRA on the last day that you are eligible, your coverage is retroactive to the date you lost your employer-sponsored health plan.

COBRA beneficiaries have 60 days to decide whether they want COBRA coverage. If you enroll in COBRA before the 60 days are up, your coverage is then retroactive, as long as you pay the retroactive premiums. This means that if you incur medical bills during your "election period," you can retroactively — and legally — elect COBRA and have those bills covered.

COBRA is expensive, but it also provides you peace of mind if you ever lose your job. Whether going with COBRA is the right choice for you depends on what you want from your health plan and how much you're willing to spend.