Ситуация
Работаю я, допустим, в компании Со1 как full time employee, и имею страховку (PPO) от BCBS. Срок действия плана заканчивается 31 дек 2005.
С 1 янв 2006 компания меняет стрховку, и переходит в другую страховую компанию. Допустим, XYZ ins. (я на самом деле названия не помню).
Задумалось мне перейти на вольные хлеба (Independent contractor).
Страховку пока терять не хочуть, т.к. семейная, сеть хорошая итд.
Существует такая хорошая вещь как COBRA, которая позволяет продолжать быть застрахованным в компании от бывшего работодателя, только мне самому надо будет платить 100% стоимости (102% если быть дотошным)
Вопросы
1) - что произойдет если я сменю работу, например, 28 декабря за 3 дня до окончания действия страховки BCBS ? По закону вроде уведомлять надо в течении 30 (60?) дней если хочешь Кобру получить, но в данном случае насколько реально keep the policy ?
2) Что произойдет если я сменю работу , например, 3-го Января ? Т.е. страховка будет уже новая. Существуют ли какие-то мнимально необходимые сроки "застрахованности! что-бы иметь возможность воспользоваться Коброй ?
В принципе я читал всякие сайты, но какого то однозначного ответа пока не нашел.
Спасибо!
Вопросы по COBRA (Health Ins.) - смена работы под новый год
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Amik
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thinker
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австралиечка
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На Кобру надо перейти в течении 30 дней со дня потери страховки. Платить надо не 100%, Кобра дает льготный тариф. Например, полная цена у Аетны 1,000 баксов, а на Кобре в течении 18 месяцев можно платить только 550 баксов. Вообще, это все от работодателя зависит. Кстати, Кобра не всем положена, там много всяких условностей
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DP
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австралиечка wrote:На Кобру надо перейти в течении 30 дней со дня потери страховки. Платить надо не 100%, Кобра дает льготный тариф. Например, полная цена у Аетны 1,000 баксов, а на Кобре в течении 18 месяцев можно платить только 550 баксов. Вообще, это все от работодателя зависит. Кстати, Кобра не всем положена, там много всяких условностей
по COBRA надо платить 100%... 100% того что получает страховка за участника группового плана от него самого и его работодателя вместе... например если я плачу $100 и мой работодатель доплачивает $300, то воспользовавшись COBRA я буду платить $400 что дешевле чем покупать такой же план "с улицы".
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Amik
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Если быть точным, то не 100% а upto 102%, т.е $408 vs $400.
DP wrote:по COBRA надо платить 100%... 100% того что получает страховка за участника группового плана от него самого и его работодателя вместе... например если я плачу $100 и мой работодатель доплачивает $300, то воспользовавшись COBRA я буду платить $400 что дешевле чем покупать такой же план "с улицы".
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Amik
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Спасибо, это я все понял.
Меня интересует именно "пограничный" период. +- неделя с момента смены страховки.
Меня интересует именно "пограничный" период. +- неделя с момента смены страховки.
австралиечка wrote:На Кобру надо перейти в течении 30 дней со дня
потери страховки. Платить надо не 100%, Кобра дает льготный тариф. Например, полная цена у Аетны 1,000 баксов, а на Кобре в течении 18 месяцев можно платить только 550 баксов. Вообще, это все от работодателя зависит. Кстати, Кобра не всем положена, там много всяких условностей
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Amik
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)
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rns
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Извините что по англииски - нет русскои клавиатуры.
COBRA legislation protects you as an employee who lost coverage. It does not matter whether you had it through BCBS or another employer-provided plan, as long as you have been covered through your place of work (i.e. if you leave your job on Jan 3rd, you would have to have been signed up for the new plan).
The employer is required to offer you COBRA upon termination (it does not matter if you have other options through your spouse or a new job) and it is your decision whether you take it or not. (Please note that employers with fewer than 20 full-time employees are not subject to COBRA legislation).
You have to elect coverage within an "election period" specified in your COBRA notice, which your employer will mail to you within 14 days of termination. An "election period" cannot be shorter than 60 days after termination of coverage. After you elect, you have another 45 days to pay for your election, which (as everyone correctly noted) would be 102% of the total cost of coverage. So, here is what you could do:
1. make sure that you are covered while you are still working (whether it is BCBS or a new plan) and that all your dependents that might want COBRA are covered as well;
2. terminate employment and shop for new individual coverage - see if it going to be cheaper than COBRA through your employer. If you are relatively healthy, you could get a high-deductible plan at 50% of the cost and even open an HSA with it;
3. then you have two options:
1) Buy individual insurance within 63 days of losing coverage (the date should be stated on your COBRA notice, sometimes employers cut you off on the last day of the month of termination not on the last day worked, i.e. you could be covered through 1/31 if you terminate on 1/3 - it's up to your employer). If you go longer than 63 days without insurance, it will qualify as a "break in coverage" and another law - HIPAA - will not protect you against pre-existing condition exclusions imposed by your new insurance carrier.
2) Elect COBRA sometime within the 60-day election period by writing to your employer (you will need a paper trail). And pay for it retroactively (all the way back to 1/3 or 1/31 whichever was the last day of employer-provided coverage) within 45 days after that - again, keep paper trail. If you don't pay in full (it could be a few months worth of 102% premiums) it would be as you never elected COBRA.
Hope this helps. Good luck!
COBRA legislation protects you as an employee who lost coverage. It does not matter whether you had it through BCBS or another employer-provided plan, as long as you have been covered through your place of work (i.e. if you leave your job on Jan 3rd, you would have to have been signed up for the new plan).
The employer is required to offer you COBRA upon termination (it does not matter if you have other options through your spouse or a new job) and it is your decision whether you take it or not. (Please note that employers with fewer than 20 full-time employees are not subject to COBRA legislation).
You have to elect coverage within an "election period" specified in your COBRA notice, which your employer will mail to you within 14 days of termination. An "election period" cannot be shorter than 60 days after termination of coverage. After you elect, you have another 45 days to pay for your election, which (as everyone correctly noted) would be 102% of the total cost of coverage. So, here is what you could do:
1. make sure that you are covered while you are still working (whether it is BCBS or a new plan) and that all your dependents that might want COBRA are covered as well;
2. terminate employment and shop for new individual coverage - see if it going to be cheaper than COBRA through your employer. If you are relatively healthy, you could get a high-deductible plan at 50% of the cost and even open an HSA with it;
3. then you have two options:
1) Buy individual insurance within 63 days of losing coverage (the date should be stated on your COBRA notice, sometimes employers cut you off on the last day of the month of termination not on the last day worked, i.e. you could be covered through 1/31 if you terminate on 1/3 - it's up to your employer). If you go longer than 63 days without insurance, it will qualify as a "break in coverage" and another law - HIPAA - will not protect you against pre-existing condition exclusions imposed by your new insurance carrier.
2) Elect COBRA sometime within the 60-day election period by writing to your employer (you will need a paper trail). And pay for it retroactively (all the way back to 1/3 or 1/31 whichever was the last day of employer-provided coverage) within 45 days after that - again, keep paper trail. If you don't pay in full (it could be a few months worth of 102% premiums) it would be as you never elected COBRA.
Hope this helps. Good luck!
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Liuka
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kron
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rns wrote:
Хопе тхис хелпс. Гоод луцк!
А вот такой вопрос: когда я уволился то я захотел оставить Кобру. Присло мне письмо где я отметил это свое желание и отслал. Было это месяца полтора назад. С тех пор ни ответа ни привета. Я особо не горюю так как все равно я Кобру не хочу так как она дорогая и с 1 Апреля у меня будет другой план.
Как мне себя вести с этой Коброй? Стоит ли звонить и отменять ее? Что будет если прийдет билл за Февраль и Март? Можно не платить? Спасибо.
Мы бьемся насмерть во вторник за среду, но не понимаем уже четверга...
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Liuka
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если отмените, то у вас может быть gap между страховками, и следующая страховка может повесить на вас все preexisting conditions, какие ей вздумается.
Но поскольку Cobra для нас в таком случае была слишком дорогой, мы подписались на BCBS Short Term ($60/month на человека, пару тысяч deductible) на два месяца.
Но поскольку Cobra для нас в таком случае была слишком дорогой, мы подписались на BCBS Short Term ($60/month на человека, пару тысяч deductible) на два месяца.
"Как вы яхту назовете, так она и поплывет." (с)
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rns
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Here is what I would do:
1. Check with the new employer if they impose pre-existing conditions. Many employers (especially large employers) choose not to have them in their group plans.
2. Check if there are any waiting periods. Some employers require that you are continuously employed (show up for work) for 30 days before you can sign up for coverage.
3. Evaluate the risk of serious illness/injury and ability to pay for it out-of-pocket between now and when the new coverage can become effective (also keeping in mind the probability of the new employer withdrawing their job offer...which rarely but happens).
4. If there are no pre-existing condition limitations, the new coverage would become effective 4/1, the employer is not looking to downsize/get acquired, etc in the next week or so, and you have no paragliding or car racing activities planned, I'd let the COBRA coverage lapse (no need to call, non-payment of premiums effectively terminates COBRA).
5. If the new employer imposes pre-existing condition limitations or if there is a waiting period, consider your health risks. If you or your dependents have pre-existing conditions (something that you or your dependnets have been seen for or diagnozed with in the past 6 mos, other than pregnancy which will always be covered), you do not want a break in coverage of more than 63 days. If the break is longer, the new plan can impose the maximum pre-existing condition period allowed by law - 12 months, during which these costs will either not be covered or covered at a reduced level (usually 50%). If the break is less than 63 days, the 12 months will be reduced by the length of previous coverage.
In this situation, if you are healthly and intend to stay that way until gaining new coverage, there is no harm in letting COBRA lapse.
If you have pre-existing conditions or there is a waiting period (during which anything can happen), you might want to make sure that:
a) you won't have a break in coverage of longer than 63 days by paying for January and possibly February COBRA depending on your date of termination and the date of new coverage (I am assuming you have made your initilial COBRA payments within 45 days of electing COBRA otherwise your COBRA would not have become effective);
b) you have some sort of short-term coverage for April if your new company has a waiting period (be it a high-deductible plan as suggested), just in case. By the way, some companies may pay your COBRA premiums while you are waiting to qualify for their group plan.
1. Check with the new employer if they impose pre-existing conditions. Many employers (especially large employers) choose not to have them in their group plans.
2. Check if there are any waiting periods. Some employers require that you are continuously employed (show up for work) for 30 days before you can sign up for coverage.
3. Evaluate the risk of serious illness/injury and ability to pay for it out-of-pocket between now and when the new coverage can become effective (also keeping in mind the probability of the new employer withdrawing their job offer...which rarely but happens).
4. If there are no pre-existing condition limitations, the new coverage would become effective 4/1, the employer is not looking to downsize/get acquired, etc in the next week or so, and you have no paragliding or car racing activities planned, I'd let the COBRA coverage lapse (no need to call, non-payment of premiums effectively terminates COBRA).
5. If the new employer imposes pre-existing condition limitations or if there is a waiting period, consider your health risks. If you or your dependents have pre-existing conditions (something that you or your dependnets have been seen for or diagnozed with in the past 6 mos, other than pregnancy which will always be covered), you do not want a break in coverage of more than 63 days. If the break is longer, the new plan can impose the maximum pre-existing condition period allowed by law - 12 months, during which these costs will either not be covered or covered at a reduced level (usually 50%). If the break is less than 63 days, the 12 months will be reduced by the length of previous coverage.
In this situation, if you are healthly and intend to stay that way until gaining new coverage, there is no harm in letting COBRA lapse.
If you have pre-existing conditions or there is a waiting period (during which anything can happen), you might want to make sure that:
a) you won't have a break in coverage of longer than 63 days by paying for January and possibly February COBRA depending on your date of termination and the date of new coverage (I am assuming you have made your initilial COBRA payments within 45 days of electing COBRA otherwise your COBRA would not have become effective);
b) you have some sort of short-term coverage for April if your new company has a waiting period (be it a high-deductible plan as suggested), just in case. By the way, some companies may pay your COBRA premiums while you are waiting to qualify for their group plan.