COBRA Health Insurance Resources for Florida Residents
If you receive your group health benefits through your employer, you may have the option to continue the coverage after your employment ends through COBRA. The Consolidated Omnibus Budget Reconciliation Act was designed by Congress requiring group health plans to provide an eligible employee a temporary continuation of group health coverage they may otherwise lose due to loss of employment or other qualifying events.
COBRA Insurance Florida: What You Should Know
COBRA in Florida is similar to COBRA in other states. However, Florida also provides a continuation of healthcare coverage for those employees working for small businesses with less than 20 employees, and who are not covered under Federal COBRA.
COBRA’s Role in Group Health Insurance
For employees, COBRA allows them to continue coverage for themselves, their spouses, former spouses, and dependent children should their group health coverage be lost due to specific events, like employment termination. Participants who choose COBRA often pay higher amounts than they typically would with traditional individual health plans. The primary reason is that the employee must pay the full price for the coverage.
Individuals Eligible for Continuation Coverage under Florida’s Mini-COBRA
For an individual to be eligible to elect Florida’s Mini-COBRA continuation coverage, a few things must happen or already be put in place:
- Federal COBRA must not cover your group health plan
- You are covered by the employer group health plan when employment terminated
- A qualifying event must occur
- You must be a qualified beneficiary of the event
- If you qualify for Medicare or another group health plan, you are not eligible for Florida Mini-COBRA
Federal COBRA covers employer-sponsored group health plans with 20 or more employees on 50 percent of typical business days in the prior calendar year. Both full and part-time employees are calculated to determine if a plan qualifies for COBRA.
Every part-time employee counts as a small part of the full-time employee, equivalent to the number of hours that the part-time employee worked then divided by the hours an employee must work to be considered full time. To become eligible for COBRA, you must have been enrolled in your employer’s health plan during employment and the policy must be in effect for current employees.
Signing Up for Florida Mini-COBRA
Unlike Federal COBRA insurance, Florida’s Mini coverage continuation is handled individually by your health insurance provider. You must send them a written notification within 30 days of losing your employment. Each insurer may have different enrollment options and participation forms. If you need help with signing up, you may want to contact the insurer directly.
Florida Mini-COBRA Insurance Cost
Just like Federal COBRA, Mini-COBRA can be a costly option for those seeking continuation coverage. The costs are based on what the employer was paying for the group insurance you participated in.
Benefits Covered Under COBRA
Once you choose continuation coverage under Federal COBRA or Florida Mini, you are given identical coverage offered under the plan to current employees and their families. You are subject to the same rules as before such as co-payment requirements and deductibles. You will be given the same benefits, choices, and services as active employee participants or other beneficiaries are getting under the plan. For example, you have the right to choose between available coverages during open enrollment season.
Reasons Your COBRA Continuation May Be Terminated
- The employer fails to keep a group health plan
- Premiums are not paid in full on a timely basis
- A qualified beneficiary becomes eligible for Medicare benefits after choosing continuation coverage
- A qualified beneficiary starts coverage under another employer group health plan before choosing continuation coverage – providing the new plan doesn’t force an exclusion or limitation concerning a preexisting condition of the qualified beneficiary
- A qualified beneficiary participates in fraudulent activities that justify the plan terminating coverage of a current participant or beneficiary
Benefits of Choosing COBRA Insurance in Florida
While COBRA may seem an expensive option, it is far better than going on uninsured. It is helpful for those with preexisting conditions that may hinder the prospect of an individual policy. If you find one, the rates may astronomical. Also, if you have a lapse in coverage plus a preexisting condition your rates may increase more than you ever thought they could.
Alternatives to COBRA Insurance in Florida
If you aren’t sure that COBRA is for you, there are other options.
- Short-term health insurance is a great solution if you are planning on being in another group health insurance but would like coverage in the interim. These plans have some limitations and strict rules about preexisting conditions and pregnancy, be sure you understand each plan before signing up.
- A high-deductible health plan may have lower monthly premiums. The caveat is you will pay more before insurance kicks in. A health savings account may be used alongside your high deductible plan.
- Your state’s health exchange might be a viable option if you lost your job as you may qualify for assistance under ACA. Another plus is that you may not have to wait until open enrollment to secure coverage.
- A traditional health insurance plan if there are no preexisting conditions. If you have health concerns or need coverage for your entire family, it may be more expensive than other options. You may also find that some conditions are excluded.
After all the considerations are made, your Florida COBRA or Mini-COBRA insurance may be the best solution for your needs.