COBRA and The New Laws

[pahealthquotes]

You nailed it. OEP is over. Dropping COBRA doesn't trigger an SEP. They had an SEP when they lost their group benefits, but once they enrolled in COBRA that SEP is over. As you said, they should have shopped before electing COBRA.

on another note... should COBRA disappear as an option? The major reason COBRA was enacted was for people with PRE X to continue on and now that reason is gone. I believe many will feel trapped once they realize what just happened.

My .02

 

[Yagents]

on another note... should COBRA disappear as an option? The major reason COBRA was enacted was for people with PRE X to continue on and now that reason is gone. I believe many will feel trapped once they realize what just happened.

My .02

Many reasons to keep Cobra:

Prices may/will be cheaper than full priced ACA for older americans.
Some may have already met their deductible/OOP for the year.
Some who are in mid-treatment need to keep doctors / drug formulary.
Some want PPO and cancer center access, vs ACA slim/HMO's.

 

[pahealthquotes]

Many reasons to keep Cobra:

Prices may/will be cheaper than full priced ACA for older americans.
Some may have already met their deductible/OOP for the year.
Some who are in mid-treatment need to keep doctors / drug formulary.
Some want PPO and cancer center access, vs ACA slim/HMO's.

agreed.... thanks for slapping me one

 

[Ann H]

Many reasons to keep Cobra:

Prices may/will be cheaper than full priced ACA for older americans.
Some may have already met their deductible/OOP for the year.
Some who are in mid-treatment need to keep doctors / drug formulary.
Some want PPO and cancer center access, vs ACA slim/HMO's.

agreed.... thanks for slapping me one

Now, tell me why we should keep HIPAA portability plans? Maybe they should go.

 

[Cenla Agent]

My apologies if this has been answered before.

What are the options if someone loses group coverage in April and wants to go with a Marketplace plan instead of COBRA? Since OEP would be past, could this be done? Since COBRA is available, would they be subsidy eligible?

 

[unic.consulting]

My apologies if this has been answered before.

What are the options if someone loses group coverage in April and wants to go with a Marketplace plan instead of COBRA? Since OEP would be past, could this be done? Since COBRA is available, would they be subsidy eligible?

Loss of current coverage is a SEP. They could qualify for subsidies unless they have already accepted the COBRA plan. Ann, correct me if I'm wrong.

 

[Ann H]

Loss of current coverage is a SEP. They could qualify for subsidies unless they have already accepted the COBRA plan. Ann, correct me if I'm wrong.

You are correct, Unic.consulting

 

[Cenla Agent]

So the only pitfall in a case such as this would be accepting COBRA and then trying to get out of it?

 

[RayNY]

Edit:Cenla, you beat me to the post. Answer to your question is Yes.

It should be noted, if they elect COBRA, they're stuck on COBRA either until the next open enrollment or expiration.

Terminating/cancelling/failing to pay COBRA is not a Qualifying Event.

 

[Ann H]

Edit:Cenla, you beat me to the post. Answer to your question is Yes.

It should be noted, if they elect COBRA, they're stuck on COBRA either until the next open enrollment or expiration.

Terminating/cancelling/failing to pay COBRA is not a Qualifying Event.

Correct, Ray. The only thing I would clarify is when you said "the next open enrollment". Just in case anyone misunderstands what Ray is saying, it could be this open enrollment as long as OE is not over - otherwise next open enrollment.