www.cms.gov Open in urlscan Pro
2a02:26f0:3500:580::28a  Public Scan

Form analysis
2 forms found in the DOM

GET /search/cms

<form region="cms_header_secondary" action="/search/cms" method="get" id="search-block-form" accept-charset="UTF-8">
  <div class="js-form-item form-item js-form-type-search form-item-keys js-form-item-keys form-no-label">
    <label for="edit-keys" class="ds-c-label visually-hidden">Search</label>
    <input title="Enter the terms you wish to search for." data-drupal-selector="edit-keys" type="search" id="edit-keys" name="keys" value="" size="15" maxlength="128" class="form-search ds-c-field" data-once="placeholder"
      placeholder="Search CMS.gov">
  </div>
  <div data-drupal-selector="edit-actions" class="form-actions js-form-wrapper form-wrapper" id="edit-actions">
    <div class="header-search-bar">
      <input data-drupal-selector="edit-submit" type="submit" id="edit-submit" value="Search" class="button js-form-submit form-submit ds-c-button ds-c-button--solid">
      <i class="fas fa-search" focusable="false"></i>
    </div>
  </div>
</form>

POST https://public.govdelivery.com/accounts/USCMS/subscribers/qualify

<form aria-label="Enter your email address for email updates" accept-charset="UTF-8" action="https://public.govdelivery.com/accounts/USCMS/subscribers/qualify" id="email-footer-form" method="post"
  data-drupal-form-fields="email-footer-input,email-submit">
  <div class="ds-u-display--flex" id="email-form">
    <div class="ds-u-display--flex ds-u-flex-direction--column flex-grow">
      <label for="email" class="ds-u-font-weight--bold ds-u-margin-bottom--1">Email</label>
      <input required="required" aria-label="Enter your email address:" name="email" type="text" placeholder="you@example.com" class="ds-c-field">
    </div>
    <div class="submit-button ds-u-margin-top--2">
      <label for="email-footer-submit" class="ds-u-visibility--screen-reader">Sign up for email updates</label>
      <button id="email-submit" class="ds-c-button ds-c-button--solid cms--external-button" name="email-footer-submit" type="submit" value="Sign up">Sign up</button>
    </div>
  </div>
</form>

Text Content

Skip to main content
U.S. Flag

An official website of the United States government Here’s how you know

Official websites use .gov
A .gov website belongs to an official government organization in the United
States.

Secure .gov websites use HTTPS
A lock ( lock ) or https:// means you’ve safely connected to the .gov website.
Share sensitive information only on official, secure websites.

Centers for Medicare & Medicaid Services


HEADER

 * About CMS
 * Newsroom

Search



CMS.GOV MAIN MENU

 * Medicare
 * Medicaid/CHIP
 * Medicare-Medicaid Coordination
 * Private Insurance
 * Innovation Center
 * Regulations & Guidance
 * Research, Statistics, Data & Systems
 * Outreach & Education
 * About CMS
 * Newsroom


BREADCRUMB

 * 
 * Programs and Initiatives
 * Other Insurance Protections
 * COBRA Continuation Coverage

CCIIO


PAGES IN THIS SECTION


 * PROGRAMS AND INITIATIVES

 * * Consumer Support and Information
   * In-Person Assistance in the Health Insurance Marketplaces
   * Health Insurance Market Reforms
   * Health Insurance Marketplaces
   * Insurance Programs
   * Other Insurance Protections
   * * COBRA
     * Mental Health Parity and Addiction Equity Act (MHPAEA)
     * Newborns' and Mothers' Health Protection Act (NMHPA)
     * Women's Health and Cancer Rights Act (WHCRA)
     * Prescription Drug Data Collection (RxDC)
     * Consolidated Appropriations Act, 2021 (CAA)
   * State Innovation Waivers
   * Premium Stabilization Programs
   * Employer Initiatives


RESOURCES

 * About Us
 * Data Resources
 * Fact Sheets and FAQs
 * Forms, Reports, and Other Resources
 * Funding Opportunities
 * Letters
 * Regulations and Guidance
 * Stakeholder Engagement
 * Training Resources


COBRA CONTINUATION COVERAGE





TABLE OF CONTENTS

 * Background
 * Premium Assistance
 * Covered Benefits
 * Extended Periods of Coverage
 * Contracted Periods of Coverage
 * Notices Required of Employers or Plans
 * Notices Required of Qualified Beneficiaries
 * Paying for Coverage
 * Other Coverage Considerations
 * Contact Information


BACKGROUND

This section provides information about COBRA continuation coverage requirements
that apply to state and local government employers that maintain group health
plan coverage for their employees.  Group health plan coverage for state and
local government employees is sometimes referred to as “public sector” COBRA to
distinguish it from the requirements that apply to private employers. The
landmark COBRA continuation coverage provisions became law in 1986. The law
amended the Employee Retirement Income Security Act of 1974 (ERISA), the
Internal Revenue Code and the Public Health Service Act (PHS Act) to provide
continuation of employer-sponsored group health plan coverage that is terminated
for specified reasons. CMS has jurisdiction to interpret and administer the
COBRA law as it applies to state and local government (public sector) employers
and their group health plans.  Individuals who believe their COBRA rights are
being violated have a private right of action.   The COBRA law only applies to
group health plans maintained by employers with 20 or more employees in the
prior year. In addition, the law does not apply to plans sponsored by the
governments of the District of Columbia or any territory or possession of the
United States, certain church-related organizations, or the federal government.
(The Federal Employees Health Benefit Program is subject to generally similar
requirements to provide temporary continuation of coverage (TCC) under the
Federal Employees Health Benefits Amendments Act of 1988.)

Individuals who work for a state or local government employer, and their
dependents, should be aware of their rights regarding COBRA. A good starting
point is reading the plan information (sometimes called a summary plan
description or SPD) provided by the employer.  If that information does not
answer your questions, you can contact the person who manages your health
benefits plan.


PREMIUM ASSISTANCE 

In General. Despite the fact that COBRA and State "mini-COBRA" laws may make
continuation coverage available to employees who lose their jobs, as well as
their dependents (qualified beneficiaries), many unemployed individuals and
family members cannot afford the cost of the continuation coverage. These
individuals may qualify for a subsidy under the American Recovery and
Reinvestment Act of 2009 (ARRA), and subsequent amendments, to help pay the
premium.  These are discussed below.

Expedited Review: Individuals who are denied access to premium assistance by
their employers or health insurance issuers can request a determination from the
Department of Labor (DOL) or the Department of Health and Human Services (HHS).
This expedited review must be completed within 15 business days after either
Department receives the request. The DOL handles all appeals regarding plans
under ERISA, while CMS, on behalf of HHS, handles all requests for review
regarding public sector (state and local government with 20 or more employees)
employer plans, federal government (including the Federal Employees Health
Benefits Program), and State continuation coverage (mini-COBRA) laws. Each
Department has developed a similar, but separate determination form.

Specific Provisions: Section 3001 of ARRA provides a subsidy to all
involuntarily terminated workers and their dependents covering 65 percent of the
cost of COBRA premiums under ERISA and the PHS Act; continuation coverage for
federal employees; and State continuation coverage premiums, if the state
continuation coverage is comparable to COBRA. Originally, premium assistance
under ARRA was available if the employee became eligible for continuation
coverage as the result of an involuntary termination that occurred during the
period from September 1, 2008 through December 31, 2009 and the employee or
family member elected continuation coverage.

 * Extension of Benefit: On December 19, 2009, the President signed into law the
   Department of Defense Appropriations Act of 2010 (2010 DOD Act), which
   extended the subsidy in several ways.
 * The end of the period for involuntary terminations was extended for two
   months, from December 31, 2010  through February 2010
 * Premium assistance was available for up to 15 months, calculated depending on
   the circumstances.
   * Individuals still receiving 9 months of premium assistance could receive an
     additional six months of premium assistance (for a total of 15 months
     coverage).
   * Individuals whose 9 months of premium assistance had already expired could
     receive up to 6 additional months if they paid the 35 percent due for
     unpaid premiums within a specified time period.
   * Individuals who continued their continuation coverage beyond the original 9
     months by paying the full amount themselves, without a subsidy, could
     receive credit or a refund for payments above 35 percent of the premium
     cost for up to 15 months.

On March 2, 2010, President Obama signed into law the "Temporary Extension Act
of 2010" (TEA) under which:

 * The end of the period for involuntary terminations was again extended, to
   March 31, 2010.
 * Eligibility for premium assistance was extended to include certain
   individuals who initially qualified for continuation coverage because of a
   reduction of hours and were later involuntarily terminated.

The TEA also provided the Departments of Labor (DOL) and Department of Health
and Human Services (HHS) the authority to impose Civil Monetary Penalties (CMPs)
on employers and insurance companies in the amount of $110 per day for failure
to comply with Expedited Review determinations (discussed above) within 10 days
after the date of the employer's or insurance company's receipt of the
determination.

The Continuing Extension Act of 2010 (CEA), signed into law on April 15, 2010,
extended the end of the period for involuntary terminations through May 31,
2010,  including where that qualifying event follows a reduction of hours
occurring from September 1, 2008 through May 31, 2010.


COVERED BENEFITS

Federal COBRA requirements only apply to employment-related group health plan
coverage.  They do not apply to individual or association health insurance
policies, and they do not apply to any non-health benefits through the employer,
such as life insurance.  

Qualified beneficiaries are generally entitled to continue the same coverage
they had immediately before the qualifying event, under the same rules. For
example, changes in the benefits that apply to active employees will apply, as
well as catastrophic and other benefit limits.


PERIODS OF COVERAGE 

In most cases, COBRA coverage for the covered employee lasts a maximum of 18
months.  However, the following exceptions apply:

29-Month Period (Disability Extension):  Special rules apply for certain
disabled individuals and family members.    If a qualified beneficiary is
determined to be entitled to disability benefits under Titles II or XVI of the
Social Security Act, and is disabled at any time during the first 60 days of
COBRA coverage, then that qualified beneficiary and all of the qualified
beneficiaries in his or her family may be able to extend COBRA continuation
coverage for up to an additional 11 months, for a total of 29 months.

However, in order to have this right, qualified beneficiaries must notify the
plan administrator about the disability determination within 60 days of the date
of the determination and before the expiration of the 18-month period. See
"Notices Required of Qualified Beneficiaries.”

18 to 36-Month Period related to Medicare eligibility (Special Rule for
Dependents):  If a covered employee becomes entitled to Medicare benefits
(either Part A or Part B) and later has a termination of employment or a
reduction of employment hours, the period of COBRA coverage for the employee's
spouse and dependent children lasts until the later of the 36-month period that
begins on the date the covered employee became entitled to Medicare, or the 18-
or 29-month period that begins on the date of the covered employee's termination
of employment or reduction of employment hours.

18 to 36-Month Period (Second Qualifying Event):  A spouse and dependent
children who already have COBRA coverage, and then experience a second
qualifying event, may be entitled to a total of 36 months of COBRA coverage.
Second qualifying events may include the death of the covered employee, divorce
or legal separation from the covered employee, the covered employee becoming
entitled to Medicare benefits (under Part A, Part B or both), or a dependent
child ceasing to be eligible for coverage as a dependent under the group health
plan. The following conditions must be met in order for a second event to extend
a period of coverage:

 1. The initial qualifying event is the covered employee's termination or
    reduction of hours, of employment, which calls for an 18-month period of
    continuation coverage;
 2. The second event that gives rise to a 36-month maximum coverage period
    occurs during the initial 18-month period of continuation coverage (or
    within the 29-month period of coverage if a disability extension applies);
 3. The second event would have caused a qualified beneficiary to lose coverage
    under the plan in the absence of the initial qualifying event;
 4. The individual was a qualified beneficiary in connection with the first
    qualifying event and is still a qualified beneficiary at the time of the
    second event; and
 5. The individual meets any applicable COBRA notice requirement in connection
    with a second event, such as notifying the plan administrator of a divorce
    or a child ceasing to be a dependent under the plan within 60 days after the
    event.  See "Notices Required of Qualified Beneficiaries,"

If all conditions associated with a second qualifying event are met, the period
of continuation coverage for the affected qualified beneficiary (or
beneficiaries) is extended from 18 months (or 29 months) to 36 months.


SHORTENED PERIODS OF COVERAGE

Continuation coverage generally begins on the date of the qualifying event and
ends at the end of the maximum period. However, a period of coverage may end
earlier if:

 * an individual does not pay premiums on a timely basis.
 * the employer ceases to maintain any group health plan.
 * after the COBRA election, an individual obtains coverage with another
   employer group health plan.
 * after the COBRA election, a beneficiary first becomes entitled to Medicare
   benefits.  (However, if Medicare entitlement, either Part A or Part B, is
   effective on or before the date of the COBRA election, COBRA coverage may not
   be discontinued on account of Medicare entitlement, even if the individual
   enrolls in the other part of Medicare after the date of the election of COBRA
   coverage.  Notices Required of Employers or Plans

Initial Notice: A group health plan (or employer) must provide an initial notice
describing COBRA rights to each covered employee and spouse of the employee (if
applicable) at the time coverage under the plan begins. The plan may send a
single notice addressed to a covered employee and the covered employee's spouse
at their joint address, provided the plan's latest information indicates that
both reside at that address. Alternatively, a plan may send separate notices to
an employee and the employee's spouse.

The plan must send a separate initial notice to a spouse under the following
circumstances: an employee receives his or her initial notice at the workplace
(in-hand delivery of the initial notice to an employee is permissible but does
not constitute delivery to the spouse); the employer or plan has knowledge that
the spouse resides at a different address than the employee; a spouse's coverage
under the plan begins at a different time than the covered employee's coverage.

Other Notices: Other notice requirements are triggered for employers and plan
administrators when a qualifying event occurs. Employers must notify plan
administrators of a qualifying event within 30 days after an employee's death,
termination, reduced hours of employment, or entitlement to Medicare (when an
employee's Medicare entitlement results in loss of plan coverage for the
employee's dependents). (An employee or other qualified beneficiary must notify
the plan administrator of certain other events within 60 days of the event, but
the employer or plan administrator is responsible for informing them of that
requirement.

Plan administrators, upon receiving notice of a qualifying event, must provide
an election notice to qualified beneficiaries of their right to elect COBRA
coverage. Because qualified beneficiaries have independent election rights, plan
administrators should either include a separate election notice for each
qualified beneficiary in a single mailing that is addressed to both the employee
and spouse, or, if a single notice is sent, it should clearly identify all
qualified beneficiaries covered by the notice and explain each person's separate
and independent right to elect COBRA coverage.

A plan administrator must always send separate election notices to qualified
beneficiaries who do not reside at the same address if the different addresses
are known to the plan administrator. A notice sent to the spouse is treated as a
notification to all qualified dependent children residing with the spouse at the
time the spouse's notification is sent by the plan administrator. Notices must
be provided in person or by first class mail within 14 days after the plan
administrator receives notice that a qualifying event has occurred.

Model Notices: The Employee Benefits Security Administration (EBSA), U.S.
Department of Labor, has issued final rules implementing private sector COBRA
notice requirements (69 Federal Register 30084 – 30112, May 26, 2004). The final
rules include a general COBRA rights notice that is issued when coverage under
the plan begins (FR page 30099), and a notice of COBRA rights that is issued
following a qualifying event (FR page 30106).
Use of the model notices is not required for public sector COBRA. However, they
are noted here because they may be helpful to state and local government
employers and their plan administrators in developing their COBRA rights
notices. State and local government employers and their plan administrators
should ensure that their COBRA rights notices are provided on a timely basis and
apprise individuals of all requirements for which an individual is responsible
in order to elect and maintain COBRA continuation coverage for the maximum
period.


NOTICES REQUIRED OF QUALIFIED BENEFICIARIES

An employee or qualified beneficiary must notify the plan administrator of a
qualifying event within 60 days after divorce (or legal separation if that
results in loss of plan coverage) or a child's ceasing to be covered as a
dependent under the plan's rules. Also, a qualified beneficiary must notify the
plan administrator within 60 days of those events when they occur during the
initial 18 or 29-month period of coverage in order to qualify for an extension
of the coverage period to 36 months.

If a second qualifying event is the death of the covered employee or the covered
employee becoming entitled to Medicare benefits, a group health plan may require
qualified beneficiaries to notify the plan administrator within 60 days of those
events, as well. Ordinarily, the employer is responsible for notifying the plan
administrator of an event that is the death of a covered employee or the covered
employee becoming entitled to Medicare benefits. However, if the covered
employee's employment has been terminated, the employer may not be in a position
to be aware of those events. If the plan does not require qualified
beneficiaries to notify the plan within 60 days of a second qualifying event
that is the death of the covered employee or the covered employee becoming
entitled to Medicare benefits, a qualified beneficiary should provide that
notice by the later of the last day of the 18-month period or the date that is
60 days after the date of the second event.

Qualified beneficiaries who wish to take advantage of the 11-month disability
extension generally must notify plan administrators of the disabled qualified
beneficiary's disability determination under the Social Security Act on a date
that is both within 60 days after the date of the disability determination and
prior to the expiration of the initial 18-month period of COBRA coverage.
However, if the date of the disability determination is before the date of the
COBRA qualifying event, a qualified beneficiary can meet the 60-day requirement
by notifying the plan administrator of the disability determination within an
alternative 60-day period specified by the plan, such as within the 60-day COBRA
election period.

The plan cannot require an individual who receives a disability determination
under the Social Security Act before experiencing a COBRA qualifying event that
is the covered employee's termination, or reduction of hours, of employment to
notify the plan of the determination within 60 days of the determination because
that requirement expressly applies to a "qualified beneficiary." An individual
whose disability determination is issued before the COBRA qualifying event is
not a "qualified beneficiary" at the time the disability determination is
issued.

If the plan does not specify an alternative 60-day period with respect to a
disability determination issued before the qualifying event, the qualified
beneficiary is required to notify the plan of the disability determination only
within the initial 18-month period of continuation coverage. Qualified
beneficiaries also must notify the plan administrator within 30 days after the
date of any final determination that a qualified beneficiary is no longer
disabled under Title II or Title XVI of the Social Security Act.

Important Note: With regard to the obligation of qualified beneficiaries to
notify the plan administrator of certain events within a 60-day period, it is
CMS's position that if a plan failed to properly inform a qualified beneficiary
regarding that obligation, the plan, in determining whether an individual
qualifies for COBRA coverage or an extension of COBRA coverage, must disregard
the qualified beneficiary's failure to meet the 60-day notification requirement.

The law plainly places the burden of informing individuals of their COBRA rights
on group health plans sponsored by state or local government employers. (Either
the employer or plan administrator must provide an initial notice of COBRA
rights when an individual commences coverage under the plan and again following
a COBRA qualifying event.) A notice of COBRA "rights" must address all of the
requirements for which an individual is responsible in order to elect and
maintain COBRA continuation coverage for the maximum period. A plan cannot hold
an individual responsible for COBRA-related requirements when the plan fails to
meet its statutory obligation to inform an individual of those requirements.


PAYING FOR COVERAGE 

Group health coverage for COBRA participants is usually more expensive than
health coverage for active employees, since usually the employer pays a part of
the premium for active employees while COBRA participants generally pay the
entire premium themselves. COBRA coverage may be less expensive, though, than
individual health coverage.
Premiums for COBRA continuation coverage cannot exceed 102 percent of the cost
to the plan for similarly situated individuals who have not experienced a COBRA
qualifying event. The cost to the plan is both the portion paid by employees and
any portion paid by the employer before the qualifying event. The COBRA premium
can equal 100 percent of that combined amount plus a 2 percent administrative
fee.

For example, if the cost of providing health benefits coverage for a similarly
situated employee who has not experienced a COBRA qualifying event is $400 per
month, $100 of which is paid by the employee and $300 of which is paid by the
employer, the plan may charge an individual a COBRA premium of up to $408 per
month (102 percent times $400). The employer is not responsible for any portion
of the individual's COBRA premium, but may, if it wishes, pay a portion, or all,
of the qualified beneficiary's premium.

For qualified beneficiaries receiving the 11-month disability-based extension of
coverage (see "Extended Periods of Coverage" for more information about the
11-month extension), the premium for those additional months may be increased
from 102 percent to 150 percent of the plan's total cost of coverage as long as
the disabled qualified beneficiary participates in the additional coverage.
Non-disabled qualified beneficiaries may participate in the additional coverage
even if the disabled qualified beneficiary does not. In that event, the plan
cannot charge the non-disabled qualified beneficiaries that participate in the
11-month extension more than the 102 percent rate for the entire period of
coverage, including the 19th through the 29th month of coverage.

COBRA premiums may be increased if the costs to the plan increase for similarly
situated non-COBRA beneficiaries, but, for COBRA purposes, such premiums
generally must be fixed in advance of each 12-month premium cycle. The plan must
allow you to pay premiums on a monthly basis, if you wish, but may give you the
option to make payments at other intervals (for example, weekly or quarterly).

You (or someone on your behalf) must make the initial premium payment within 45
days after the date of your COBRA election; the payment generally must cover the
period from the coverage loss date through the month in which the initial
payment is made. However, if you only need COBRA coverage for a short period of
time, such as one or two months, you can pay only for those months from the
coverage loss date.

After you make the initial premium payment, subsequent premiums (usually paid on
a monthly basis) are considered to be timely if made by the date due or within a
grace period of 30 days after the date due (or longer period as applies to or
under the plan). Payment is considered to be made on the date it is sent to the
plan.

If you do not make premium payments by the first day of the period of coverage,
the plan has the option to cancel coverage until payment is received and then
reinstate the coverage retroactively to the beginning of the period of coverage
if payment is made within the grace period. Alternatively, the plan can hold any
claims received during the grace period and then process them if the premium
payment is made within the grace period, or deny them and terminate coverage
effective the first day of the period of coverage for which payment is not made
within the grace period.

If the amount of the payment you make to the plan is in error but is not
significantly less than the amount due, the plan may accept the payment as
satisfying the plan's requirement for the amount that must be paid.
Alternatively, the plan is required to notify you of the deficiency and grant a
reasonable period (for this purpose, 30 days is considered reasonable) to pay
the difference. The plan is not obligated to send monthly premium notices or
payment coupons.
COBRA beneficiaries remain subject to the rules of the plan and therefore must
satisfy all costs related to co-payments and deductibles.


OTHER COVERAGE CONSIDERATIONS

In deciding whether to elect COBRA continuation coverage, you should consider
all your health care options.  

 * For instance, one option that may be available is "special enrollment" in a
   group health plan sponsored by a spouse's employer, if enrollment is
   requested within 30 days of loss of your health coverage.  (If you decide to
   elect COBRA coverage under your plan, special enrollment also is available in
   a spouse's plan after COBRA continuation coverage is exhausted).  The special
   enrollment right is provided by the Health Insurance Portability and
   Accountability Act of 1996 (HIPAA) and permits an individual who loses group
   health plan or health insurance coverage to enroll in a spouse's plan without
   having to wait for an open enrollment period.  If a group health plan
   provided by a spouse's employer is insured by a health insurance carrier,
   contact your state's department of insurance for more information about
   special enrollment rights.  Also, regarding special enrollment in a plan
   maintained by a state or local government employer, you can contact CMS at
   phig@cms.hhs.gov.

If the group health plan provided by a spouse's employer is a self-funded,
private sector (not a state or local government) plan, contact the Employee
Benefits Security Administration, Department of Labor (telephone #
1-866-444-3272 (toll free) or 202-219-8776).

 * Also, individuals in a family may be eligible for health insurance coverage
   through various state programs, such as Medicaid or the Children’s Health
   Insurance Program.  For more information about state programs, contact your
   state's department of insurance or Medical Assistance (Medicaid) office.
 * Additionally, you and your family may qualify for individual health insurance
   coverage as "HIPAA-eligible individuals" when COBRA coverage is exhausted.
   (COBRA coverage is exhausted when it ends for any reason other than either
   failure of the individual to pay premiums on a timely basis or for cause,
   such as making a fraudulent claim.)

HIPAA eligible individuals are eligible to purchase individual health coverage
on a guaranteed available basis with no exclusion period for preexisting medical
conditions.  Certain criteria must be met.  For more information about obtaining
individual health coverage as a "HIPAA-eligible individual," contact your
state's department of insurance, preferably before your COBRA coverage ends.
 Also, you can contact CMS at 1-877-267-2323, option 6, extension 61565.  See
the Important Note below about the interaction of HIPAA eligibility and
conversion options.  

If you elect COBRA continuation coverage, some options that were available to
you before electing COBRA coverage may still be available after COBRA coverage
is exhausted.

 * Although COBRA specifies certain minimum periods of time that continued
   health coverage must be offered to qualified beneficiaries, COBRA does not
   prohibit plans from providing continuation coverage beyond the periods
   required by COBRA.
 * Also, some plans provide an opportunity for participants and beneficiaries to
   “convert” to an individual health insurance policy instead of electing COBRA
   continuation of group coverage. If this option is available from the plan,
   and if you choose COBRA rather than the conversion option, the COBRA law
   gives you the right to exercise that option when you reach the end of your
   COBRA continuation coverage.  The plan must offer a qualified beneficiary the
   option of enrollment in a conversion health plan within 180 days before COBRA
   coverage ends.  The premium for a conversion policy may be more expensive
   than the COBRA premium, and the conversion policy may provide a lower level
   of coverage.  The federal law requirement regarding the conversion option is
   not available if the qualified beneficiary ends COBRA coverage before
   reaching the end of the maximum period of COBRA coverage.

Important Note: One of the conditions that must be met to obtain individual
health coverage as a HIPAA-eligible individual is that the individual's most
recent period of coverage must be employer-sponsored group health plan coverage.
 COBRA coverage meets that requirement.   A “conversion policy” does not.  A
conversion policy is individual market coverage, so choosing a conversion policy
forfeits the right to later switch to other individual health coverage on a
guaranteed available basis as a HIPAA-eligible individual.


CONTACT INFORMATION

If you are unable to find the COBRA-related information you are looking for on
this Website, you may e-mail us at phig@cms.hhs.gov.  Below are other sources of
information about continuation coverage benefits, and subsidies and other rights
under ARRA.

 1. Centers for Medicare & Medicaid Services (CMS). For assistance with
    questions regarding premium assistance for continuation coverage please
    contact CMS via email at phig@cms.hhs.gov or call toll free at
    1-877-267-2323, option #6, extension 61565.
 2. State Departments of Insurance (DOIs). Your State DOI can advise you whether
    it requires State continuation coverage (or mini-COBRA plans) and, if so,
    whether it considers that coverage "comparable" such that you might qualify
    for ARRA premium assistance.
 3. Department of Labor (DOL). DOL’s Employee Benefits Security Administration
    (EBSA) shares jurisdiction with IRS over private sector COBRA.   EBSA has
    lead authority with respect to reporting and disclosure provisions, which
    includes requirements that plans notify individuals of their right to elect
    COBRA continuation coverage.  DOL is also responsible for reviewing denials
    of premium assistance as discussed above.  You can reach EBSA at
    1-866-444-3272 or through its website.  
 4. The Department of the Treasury (Treasury) and the Internal Revenue Service
    (IRS). Treasury through the IRS oversees tax issues for all individuals and
    group health plans affected by the ARRA premium assistance. The IRS website
    contains detailed information.


UPDATES

 * March 5, 2020 Information Related to COVID–19 Individual and Small Group
   Market Insurance Coverage
 * March 12, 2020 FAQs on Essential Health Benefits Coverage and the Coronavirus
   (COVID-19)
 * March 18, 2020 FAQs on Catastrophic Plan Coverage and the Coronavirus Disease
   2019 (COVID-19)
 * March 24, 2020 FAQs on Availability and Usage of Telehealth Services through
   Private Health Insurance Coverage in Response to Coronavirus Disease 2019
   (COVID-19)
 * March 24, 2020 Payment and Grace Period Flexibilities Associated with the
   COVID-19 National Emergency
 * March 24, 2020 FAQs on Prescription Drugs and the Coronavirus Disease 2019
   (COVID-19) for Issuers Offering Health Insurance Coverage in the Individual
   and Small Group Markets
 * April 11, 2020 FAQs about Families First Coronavirus Response Act and the
   Coronavirus Aid, Relief, and Economic Security Act Implementation
   *This document was updated on April 15, 2020, to correct an error in footnote
   10 regarding the current end date of the public health emergency related to
   COVID 19.
 * April 13, 2020 Postponement of 2019 Benefit Year HHS-operated Risk Adjustment
   Data Validation (HHS-RADV)


GET EMAIL UPDATES

Sign up to get the latest information about your choice of CMS topics. You can
decide how often to receive updates.

Email
Sign up for email updates Sign up


CMS & HHS WEBSITES CMS & HHS WEBSITES

 * Medicare.gov
 * Medicaid.gov
 * InsureKidsNow.gov
 * HealthCare.gov
 * HHS.gov
 * HHS.gov/Open


ABOUT CMS ABOUT CMS

 * About Us
 * Careers
 * Newsroom
 * Blog
 * Podcast


TOOLS TOOLS

 * Acronyms
 * Archive
 * Contacts
 * Glossary


HELPFUL LINKS HELPFUL LINKS

 * Web Policies
 * Privacy Policy
 * Plain Language
 * Privacy Settings Privacy Settings
 * Nondiscrimination & Accessibility
 * Developer Information


USA GOVERNMENT SITES USA GOVERNMENT SITES

 * Freedom of Information Act
 * No Fear Act
 * Inspector General
 * USA.gov


CONNECT WITH CMS

 * Linkedin link
 * Youtube link
 * Facebook link
 * Twitter link
 * RSS Feed link

A federal government website managed and paid for by the U.S. Centers for
Medicare & Medicaid Services.

7500 Security Boulevard, Baltimore, MD 21244




Feedback