How COBRA Insurance works?

This is a federal law that may allow you to temporarily continue health coverage offered by employers to covered employees, their spouses, former spouses, and dependent children when group health coverage would otherwise be lost due to end of employment. If you elect COBRA (Consolidated Omnibus Budget Reconciliation Act) coverage, you pay 100% of the premiums, including the share the employer used to pay, plus a small administrative fee.
The law generally applies to all group health plans maintained by private-sector employers with 20 or more employees, or by state or local governments. The law does not apply to plans sponsored by the Federal Government or by churches and certain church-related organizations. In addition, many states have laws similar to COBRA, including those that apply to health insurers of employers with less than 20 employees (sometimes called mini-COBRA). Check with your state insurance commissioner's office to see if such coverage is available to you.

Are there COBRA alternatives for health coverage?

If you decide not to take COBRA coverage available through your employer, you can enroll in a Marketplace plan. Losing job-based coverage qualifies you for a Special Enrollment Period. You must enroll in a marketplace health plan, within sixty days even if it’s outside the annual Open Enrollment Period.

What is advance Premium Tax Credit (APTC)

The Advanced Premium Tax Credit is available to those who buy their own health coverage in the federal or state health insurance marketplace. Your APTC is calculated based on your estimated annual household income, household size and where you live. If your income or family size changes, this may impact the APTC you receive. There are two kinds of subsidies: the advanced Premium Tax Credit and Cost Sharing Reduction (available only for “Silver Plans”). Check if you qualify for APTC

If you qualify for a premium tax credit or CSR based on your income estimate, you can use any amount of the credit in advance to lower your premium.

Who is eligible?

You may be eligible for the premium tax credit if,

  • • Your household income is between 100 - 400 percent of the Federal Poverty Level. For example: when you buy coverage for 2021, you can use the FPL published for 2020
  • • Not eligible for health insurance through Medicaid or Medicare
  • • Not claimed as a dependent by another person
  • • Not eligible for affordable coverage through an eligible employer-sponsored plan that provides minimum value

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