Employer based health insurance provides coverage for tens of millions of Americans. Unfortunately, many employees will be without coverage if they lose their job, quit, retire or if their company goes out of business. In most cases, an employee can elect COBRA upon losing employment. The Consolidated Omnibus Budget Reconciliation Act will provide 18 months of additional coverage so long as the group consisted of 20 or more employees.
In Ohio, if the group is under 20 employees COBRA allows for up to six months of coverage. This law is sometimes referred to as”Baby COBRA.” There are certain rules regarding who is eligible to elect COBRA and what the cost will be, but in all cases COBRA is temporary insurance for the insured. In addition, the expense to the former employee can be significant. Ultimately, the cost will be determined by the premiums for the former plan plus a 2% administrative fee. Former employees are often surprised to discover how much it will cost to elect their company insurance through COBRA.
Once their COBRA benefits have run out, individuals and families will need to search the individual health market. If you are in good health, usually there are few problems obtaining an individual or family policy. However, if the former insured is in poor health – finding a comprehensive policy can be very difficult. (Editor’s note: Due to healthcare reform, those in poor health cannot be turned down for health insurance during a qualifying event.)
There are providers who will insure high risk individuals, but typically the benefits to the insured are far less than their employer sponsored plan. When possible, an individual in poor health may only be able to find adequate coverage in another employer sponsored plan. The state of Ohio does offer an HMO plan providing open enrollment with select companies. The coverage offered will vary by county and the enrollment window will differ from company to company. However, you can expect these plans to be very expensive.
Thus, it is advisable to explore your options as soon as you lose your employer sponsored coverage. COBRA can be helpful, but because it is not permanent, new coverage will usually be needed at some point. One potentially difficult scenario can be easily avoided by shopping for insurance early.
Electing COBRA while in good health and waiting to apply for permanent coverage until the allotted 18 months expires is a risky proposition. What if your health changed for the worse during that period of time? You may have difficulty finding coverage in the individual market. However, you would have been insurable had you applied for a plan immediately after becoming unemployed. In many cases, the permanent individual coverage would be less expensive as well.
In summary it is always advisable to obtain permanent health insurance coverage while you are in good health. Once accepted, you can keep this coverage for as long as you need it. If you rejoin a group plan later, you may elect to drop the coverage or maintain it if you feel that you have a superior plan.
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Category: Health Insurance