The Consolidated Omnibus Budget Reconciliation Act, or COBRA, is a federal program that helps employees retain health insurance benefits when they lose their employer-sponsored health coverage. COBRA can be a great asset to you and your family if you lose your job or have to cut down your work hours.
However, employers or plan administrators can make mistakes. When they do, or if they unlawfully deny you COBRA coverage, you could be entitled to benefits and damages.
What is COBRA?
COBRA is a federal law that allows employees who are on employer health plans to retain health insurance benefits for themselves and their family. It springs into action when an employee loses their job or is forced to cut down their work hours.
Benefits through COBRA only last for a limited period of time, but they can help you get through difficult health situations or times of unemployment.
Who can receive COBRA benefits?
To be eligible for COBRA, you must be a “qualifying beneficiary.” Essentially, this means that you must:
- Have previously been on an employee group health plan
- Have been on this plan for at least half of the business days in the prior calendar year
- Receive eligibility through an employer who has more than 20 employees in its group health plan
Beneficiaries can include not only employees covered by group health plans but also the spouses, former spouses, and children of employees.
When do I become eligible to receive COBRA benefits?
Beneficiaries can receive COBRA continuation coverage when a “qualifying event” occurs that causes them to lose group health coverage. A qualifying event could include the employee’s job loss or the death or divorce of the employee.
Can I lose eligibility for COBRA?
The short answer to this is yes. It is possible to lose your eligibility for COBRA if your employer cancels your group health insurance plan or if you have not paid the plan premiums. You might also lose COBRA benefits if you go on Medicare or enroll in a different employer-provided plan.
When should I tell my employer I want COBRA benefits?
If a change in employment status is the reason you are electing to use COBRA, you should notify your employer or plan administrator of your intent as soon as your employment status changes. Your employer is obligated to notify the group plan about the qualifying event.
If you experience a life event like divorce that requires you to use COBRA, you have 60 days to tell your plan administrator about the event and your election of COBRA.
Employers or plan administrators have to meet federal requirements for providing COBRA in Georgia and Florida, so the sooner you can notify them that you elect to use COBRA, the better.
When does my employer have to give me notice about my COBRA rights?
Employers must provide certain information about COBRA rights within 90 days after the employee becomes part of the insurance plan. After a plan is notified about the qualifying event that triggers COBRA eligibility, your plan administrator has 14 days to respond and give you notice about your COBRA rights.
If your employer is your plan administrator, they may have some additional time to send your election notice—usually 44 days.
What happens if my employer doesn’t give me notice about my COBRA rights?
Employers are required to provide notice to their employees when they have the option to choose COBRA and continue their health insurance coverage. If they fail to do so, they could face fines or be required to cover medical costs incurred during the delay.
You may also have the option to sue your employer or plan administrator for not giving you notice. This could entitle you to additional damages or compensation for attorneys’ fees.
What can I do if I am denied COBRA?
If you receive a notice that says you are not eligible for COBRA, but you actually are, this mistake could result in a penalty for your employer. Other situations in which your employer or plan administrator might have violated your rights include:
- Not getting a COBRA notice at all
- Not receiving all appropriate documents
- Receiving an incomplete notice without the required information
- Getting a notice that is too complicated to understand
Overall, it’s best to talk to an attorney if you feel there’s been a mistake with your COBRA coverage. You could be entitled to benefits or damages, and a lawyer can help you verify your eligibility and build your case.
Pursue COBRA Relief with an Attorney in Florida and Georgia Today
If you have been unlawfully denied COBRA coverage, call an experienced attorney from The Leach Firm today at (844) 722-7567 to schedule a free consultation. We provide legal service to clients in Florida and Georgia.