Am I eligible for Mini-COBRA if I resign?

[starkos]

After much Googling, I'm still confused: I work for a small company in PA, a state with a "mini-COBRA" plan. Am I eligible if I resign my position, or only if I get laid off?

The guidelines state that I would be eligible upon "voluntary or involuntary" termination of employment, excepting gross misconduct. My understanding is that I *would* be eligible.

Many thanks!

[cantlogin]

It worked for me.

[dgoldenz]

Quote:

Originally Posted by starkos After much Googling, I'm still confused: I work for a small company in PA, a state with a "mini-COBRA" plan. Am I eligible if I resign my position, or only if I get laid off? The guidelines state that I would be eligible upon "voluntary or involuntary" termination of employment, excepting gross misconduct. My understanding is that I *would* be eligible. Many thanks!

This link might help you: Pennsylvania Adopts "mini-Cobra" Law for Small Employers

Just keep in mind that you don't get the COBRA subsidy if you leave on your own. Are you not healthy enough to get underwritten coverage?

[starkos]

Sorry, not that I disbelieve you, but I don't see how that link addresses it. It does state there is a federal subsidy that only applies to involuntarily terminated employees, but I don't see where it answers the broader question of eligibility (without the subsidy).

I guess I'm confused on what constitutes "voluntary termination". I've started looking for a broker to help me get this straightened out, but would still appreciate any feedback (thanks to @cantlogin also).

The reason I'm trying to go the COBRA route is because my work situation has gone south in the last week and I would like to get out before it gets any worse. I've got money saved and could line up projects quickly, but I would like time to research and select an HSA.

[dgoldenz]

Here's a more detailed link: Pennsylvania’s Mini-COBRA Law

Voluntary termination is still ok for eligibility, but apparently if you over $250k as a couple or $125k single, you are disqualified.

[starkos]

Thanks again. I did see that link, and interpreted "voluntary termination" as resigning.

The income limits are, by my read, only for the federal subsidy. I would still be covered under COBRA, but will be paying the full amount myself. As I understand it.

[dgoldenz]

Quote:

Originally Posted by starkos Thanks again. I did see that link, and interpreted "voluntary termination" as resigning. The income limits are, by my read, only for the federal subsidy. I would still be covered under COBRA, but will be paying the full amount myself. As I understand it.

You could be right, the article isn't very clear. It says "subsidy" after the income limits, but is in the same paragraph as eligibility for the mini-cobra itself.

[Martha]

Voluntary termination is a euphemism for quit.

[Buckeye]

Go with individual insurance if you qualify. We have been extemely pleased with our high deductible ($5,000 per person) health insurance policy. It's a high deductible but I'd rather spend my money paying for actual direct costs than give it to the insurance company as premium payments.

You don't want anything to happen to you while on COBRA that will cause you not to be insurable on an individual policy when the COBRA runs out. If you already have existing conditions that will put you out of the individual market, I guess COBRA is your only option.

[gquiring]

Your group plan is probably better than anything you can get with an individual plan. I lost my job because the company went out of business so there was no COBRA offering. The individual plans not only cost more than a group plan they offer less.

In my case I had an HMO plan with my employer. $15 copays and I was 100% covered. My employer was paying ~$400 a month for me. When I tried to convert the plan over to an individual it went to $900 a month and had 50% coinsurance + copay on all prescription drugs (no cap which is crazy expensive) and my hospital stay was now $300 per day with a 15 day cap. Copays went to $30. Plus the plan had a lot of restrictions that did not exist with the group coverage.

You must make sure you don't have a gap in coverage to cover pre-existing conditions. As long as you get your COCC from your current provider you can switch and be covered for any conditions you might have.

This link says you can quit your job and be eligible for COBRA:
Cobra insurance coverage

[Buckeye]

I highly recommend you engage the services of an insurance broker who has extensive experience in individual health insurance policies. You pay them nothing directly for their service. IMHO, a knowledgeable broker is extremely important in this complicated field.

We would have never found the individual plan we have (which is a great fit for us at a reasonable cost) without the help of our local insurance broker. We knew they were good because it was a small town and they had been in business for 25 years.

COBRA was going to be too expensive (even with the subsidy) and there was the very real fear (we are 51 & 60 years old) a health issue might arise while on COBRA that would make us uninsurable for an individual policy. We bypassed COBRA and went straight to an individual high-deductible policy with an HSA.

[dgoldenz]

Quote:

Originally Posted by gquiring Your group plan is probably better than anything you can get with an individual plan. I lost my job because the company went out of business so there was no COBRA offering. The individual plans not only cost more than a group plan they offer less. In my case I had an HMO plan with my employer. $15 copays and I was 100% covered. My employer was paying ~$400 a month for me. When I tried to convert the plan over to an individual it went to $900 a month and had 50% coinsurance + copay on all prescription drugs (no cap which is crazy expensive) and my hospital stay was now $300 per day with a 15 day cap. Copays went to $30. Plus the plan had a lot of restrictions that did not exist with the group coverage. You must make sure you don't have a gap in coverage to cover pre-existing conditions. As long as you get your COCC from your current provider you can switch and be covered for any conditions you might have. This link says you can quit your job and be eligible for COBRA: Cobra insurance coverage

Individual insurance is almost always less expensive than a comparable group plan unless you are very unhealthy or in the 55+ age range and want a very comprehensive low-deductible plan. Even if he is eligible for mini-COBRA, it only lasts for 9 months. If something happens to the OP's health in those 9 months and they become uninsurable, they will be forced to buy the most expensive policies available under HIPAA conversion rules. Some states have risk pools for the unhealthy too. As Buckeye said, make sure you get in contact with an independent agent who knows the ins-and-outs of your state rules for continuation of coverage. I would advise to find a broker who sells for all of the major health insurance companies in your state, rather than just one or two companies.

[starkos]

Many thanks for all the replies and good advice. I am starting the search for a good insurance broker now, but have the peace of mind that I will be covered under mini-COBRA so I don't have to rush into anything. I gave my notice on Friday and HR confirmed the event was "voluntary termination." So I've jumped...now to try out these wings I've been building!

[ziggy29]

Quote:

Originally Posted by dgoldenz Even if he is eligible for mini-COBRA, it only lasts for 9 months. If something happens to the OP's health in those 9 months and they become uninsurable, they will be forced to buy the most expensive policies available under HIPAA conversion rules.

Pretty sweet deal for someone who is less than 65 but at least 64 years and 3 months, though...