Hawai‘i Insurance Continuation Program (H-COBRA)
The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost of the plan.
COBRA generally requires that group health plans sponsored by employers with 20 or more employees in the prior year offer employees and their families the opportunity for a temporary extension of health coverage (called continuation coverage) in certain instances where coverage under the plan would otherwise end.
H-COBRA is a Hawai‘i program specifically for people with HIV. H-COBRA can pay premiums to continue health insurance for people who are COBRA eligible but cannot afford the cost of the premium.
In some situations, H-COBRA can pay premiums for individuals who are no longer eligible for group coverage (including COBRA), but who are eligible to convert from group coverage to an individual “HIPAA conversion plan” under the provisions of the Health Insurance Portability and Accountability Act (HIPAA). Note that H-COBRA cannot provide premium payments for the many HIPAA conversion plans that lack prescription drug coverage.
Who is eligible for H-COBRA? To be eligible for H-COBRA, an individual must:
- Live in Hawai‘i
- Be HIV positive
- Be eligible for insurance continuation under federal COBRA guidelines (or for conversion to an individual plan under the HIPAA guidelines)
- Have income below 300% of the Federal Poverty Level for Hawai‘i ($37,380 per year for a single person in 2010)
How does someone apply for H-COBRA? Contact the HIV Case Management agency on your island for assitance applying for H-COBRA.
Can I still continue my health coverage if I just lost my job?
Contact your health plan to see if COBRA coverage is a benefit provided in your current health plan. COBRA is a federal law that gives some employees and their dependents the option to continue health insurance. Your health plan must give you a notice stating your right to choose to continue coverage under the plan. You will have 60 days from the date of the notice to choose COBRA coverage or lose all rights to benefits. For more information on COBRA contact the U.S. Department of Labor, Employee Benefits Security Administration (EBSA, formerly known as the (PWBA) Pension and Welfare Benefits Administration) at 1-866-444-3272 or log on to www.dol.gov/ebsa/welcome.html.