2

I recently elected COBRA coverage, and a few weeks later my wife left her job. She has access to her own COBRA coverage from her job, but we'd prefer her to be on my plan rather than hers. My COBRA benefits administrator said that she can only be added during open enrollment -- is that true? Does she not qualify for a special enrollment period under our COBRA group plan given that she no longer has coverage from her employer?

If she does qualify for special enrollment, it would be great to know the exact parts of HIPAA that grant her special enrollment.

1 Answer 1

4

COBRA isn't a plan, it's a rule that says your employer (or employer group or union etc) based health coverage needs to allow you to continue participating in the plan after you lose eligibility. When you find yourself in a COBRA enrollment window, you are only permitted by the rules to extend the elections you had already made. As an example, if you were covered by the HDHP as employee only, you can't change that to the PPO as employee + spouse until the plan's open enrollment.

For COVID ARPA included some emergency COBRA relief provisions required in 2021, but to my knowledge those have all since expired.

COBRA is not her only option, her coverage loss would give her an enrollment window to purchase coverage from either your state or the federal exchange. But your employer's plan is generally not an option as your COBRA administrator has indicated. It's early enough in the year that accrued deductibles or plan maximums probably aren't an issue. At this point, with guaranteed issue individual coverage available, the most common reason to elect COBRA is the person has already met the plan maximum and has scheduled treatment.

Your Answer

By clicking “Post Your Answer”, you agree to our terms of service, privacy policy and cookie policy

Not the answer you're looking for? Browse other questions tagged or ask your own question.