Health Coverage Update

Amy MasciolaHealth Care, StrikeLeave a Comment

Although the company does not have to cut off your health insurance coverage, we fully expect them to as of October 31st if we remain on strike. We recommend that all members take advantage of this brief window of opportunity to get medical and dental check ups and fill prescriptions, whatever you need to do while you have good coverage. Below you will find some information on COBRA health coverage.

COBRA

COBRA guarantees continuation of coverage, at a significantly higher cost, for previously covered employees, their spouses, former spouses, and dependent children. For more information, click here, http://www.dol.gov/ebsa/faqs/faq-consumer-cobra.html.

Two other important points: 

1. The employer must give you an election period of at least 60 days (starting on the later of the date you are furnished the election notice or the date you would lose coverage) in which to choose whether or not to elect continuation coverage. Each of the qualified beneficiaries may independently elect COBRA coverage. This means that if both you and your spouse are entitled to elect continuation coverage, you each may decide separately whether to do so. The covered employee or spouse must be allowed to elect on behalf of any dependent children or on behalf of all of the qualified beneficiaries.

2. If you waive COBRA coverage during the election period, you must be permitted later to revoke your waiver of coverage and to elect continuation coverage as long as you do so during the election period (60 days). Then, the plan need only provide continuation coverage beginning on the date you revoke the waiver.

MARKETPLACE

There are options (typically cheaper) other than COBRA. One coverage option is the new health insurance marketplace (Marketplace). The Marketplace offers health insurance that includes comprehensive coverage, from doctors and medications to hospital visits. Qualified health plans in the Marketplace present their price and benefit information in simple terms so that you can make apples-to-apples comparisons. For more information, visit healthcare.gov, or

VT Marketplace: http://hcr.vermont.gov/timeline/exchange
NH Marketplace: http://www.coveringnewhampshire.org/
ME Marketplace: http://www.maine.gov/pfr/insurance/ACA_Index.html

SPECIAL ENROLLMENT

Another option may be “special enrollment” into other group health coverage. Under the Health Insurance Portability and Accountability Act (HIPAA), if you or your dependents are losing eligibility for group health coverage, you may have a right to special enroll (enroll without waiting until the next open season for enrollment) in other group health coverage. For example, an employee losing eligibility for group health coverage may be able to special enroll in a spouse’s plan. A dependent losing eligibility for group health coverage may be able to enroll in a different parent’s group health plan. To have a special enrollment opportunity, you or your dependent must have had other health coverage when you previously declined coverage in the plan in which you now want to enroll. To special enroll, you or your dependent must request special enrollment within 30 days of the loss of other coverage.