Government Subsidy Increases COBRA Unemployment Health Insurance Affordability

In 1986, Congress passed the Consolidated Omnibus Budget Reconciliation Act, COBRA, as a means for former employees, spouses, and dependent children to continue the group health insurance previously provided by an employer. The coverage was paid completely by the insured. In many cases, the cost of the coverage was prohibitively high, especially if the premiums were being paid for out of unemployment benefits. In light of the rising unemployment rate and the cost of health insurance, the affordability of COBRA gained government attention. The American Recovery and Reconciliation Act of 2009 (ARRA) includes a provision to reduce the cost of continuation coverage to eligible laid-off workers by 65%.

How the Subsidy Works

The COBRA subsidy became effective as of March 1, 2009 for workers laid-off between September 1, 2008 and December 31, 2009. Anyone who became involuntarily unemployed during this time period and had been covered by group health insurance provided by the former employer must be notified of the availability of the subsidy by April 18, 2009. The subsidy is available for nine months of coverage unless another group health insurance is available or the worker becomes eligible for Medicare. Generally, COBRA is available for 18 months.

The subsidy is in the form of a tax credit for employers at the rate of 65% of the cost of COBRA for former employees, eligible spouses and dependent children. Those receiving the benefit will only be billed for the remaining 35% of the premium. Employees who lost their job during the qualifying time period and declined coverage before ARRA was enacted are now eligible to receive coverage. The enrollment period for accepting coverage is 60 days from the date of unemployment. The reduced premium is only applicable to payments from March 1, 2009 forward.

Employers with 20 employees or less are not required to provide COBRA continuation coverage under Federal law; however several states do require small businesses to participate if it offers coverage to retained workers. If the former employer no longer offers group health insurance either due to dropping the coverage for remaining workers or through business closure, COBRA coverage is no longer available.

Who is Eligible for the COBRA Subsidy

People who became unemployed through no fault of their own and whose former employer maintains group health insurance are eligible for coverage subject to certain income limits. The subsidy is not available for people who have a modified adjusted gross income in excess of $145,000 or $290,000 for those filing a joint return and is phased out beginning at $125,000/$250,000 income level. If a laid-off worker is eligible to receive health insurance through a spouse's employer or Medicare, the subsidy does not apply.

COBRA Information Resources

As the subsidy and associated changes to COBRA continuation coverage is so new, there may be a time between when the subsidy became law and when it is actually put into action. The U.S. Department of Labor has a website in place with detailed information about the new law, how it applies to individual situations, and includes an option to subscribe to the page for notification as updates become available. Benefits Advisers with the Department of Labor are also available toll free (866) 444-3272 for more information.