Q: My son had a teaching job in a school district with a plan which provided coverage for IVF when trying to have a baby. We got a new job at a school district that provides health insurance but does not include some of those coverages when trying to have a baby. What are his options for continuing on cobra with his prior employer so that he can continue to have this coverage for awhile?
A: He has three options:
1. He can elect COBRA through his previous employer. If he does this, he will keep his same coverages, but it will cost him more than it did while he was employed. This is because instead of just paying part of the premium, he will pay what he paid before, PLUS the employer contribution, plus a 2% administrative fee. The premiums alone can be pricey.
Also, with COBRA he would have to elect it within 60 days of the date of the loss of coverage. The employer has up to 45 days to send that packet in the mail. Although that may seem like a long time, if elected the coverage will work retro-actively back to the date of the loss of coverage, making it like there was no gap in coverage. The retro-active coverage ONLY works if COBRA is elected.
Lastly, remember that COBRA doesn’t last forever; it is meant to be temporary . It will expire after 18 months unless another coverage is found, or another qualifying event (for COBRA) occurs. Also, know that you cannot keep COBRA if you have other coverage.
2. He can use his loss of employer coverage as a special enrollment period to enroll in an qualified health plan. Healthcare Reform requires a person to have a qualifying event to enroll in a non-group health plan outside of Open Enrollment. One qualifying event is losing job-based coverage. Your son has a 60-day window during which he can enroll in a plan, if he doesn’t go with a plan offered by either employer.
3. He can accept coverage from the new employer and pay what insurance doesn’t cover.