What is
COBRA?
COBRA is an acronym that stands for the Consolidated Omnibus Budget Reconciliation Act of 1985. This federal law allows employees the right to continue participating in their group health insurance coverage after leaving their job. COBRA gives participants, who would otherwise lose coverage as a result of certain events, the opportunity to temporarily continue their group health care coverage under their employer’s plan on a self pay basis.
HOW DOES PROGRESSIVE BENEFIT SOLUTIONS HELP?
Progressive Benefit Solutions, LLC is the billing entity for qualified beneficiaries who enroll through COBRA while the insurance carrier still oversees the coverage aspect of benefits. We are the advocate to ensure appropriate notifications are provided, process elections, bill and record premium payments to ensure paid in full. We notify COBRA participants of plan and rate changes when health plans renew as well as notifying insurance carriers of the enrollment changes. We are here to help you through the process of all the necessary COBRA/HIPAA administration.
ALL ABOUT COBRA
1 Employer sends eligibility file to PBS
2 PBS sends COBRA Specific Rights Notice and election information to qualified beneficiaries (QBs)
3 QBs elect coverage and make payments for each month they’d like to continue coverage
4 PBS communicates eligibility and coverage changes to insurance carriers
COBRA Insurance Continuation Guide
COBRA allows you to continue your employer health plan for a limited time after certain life events. You’ll pay up to 102% of the total premium while you transition to a new plan. Use this guide to understand eligibility, timelines, costs, and the enrollment process.
Employers seeking assistance with managing notices and billing can visit our COBRA administration service page.
Who Qualifies
You may be eligible after a qualifying event such as job loss, a reduction in hours, divorce or legal separation, death of the covered employee, or a child aging out of coverage. Your plan sponsor or administrator will confirm eligibility and send a COBRA election notice. COBRA coverage may be offered to employees, dependents, or a spouse. New dependents gained during COBRA (for example, birth or adoption) may also be eligible.
COBRA is not a health insurance plan. The Consolidated Omnibus Budget Reconciliation Act protects you and your family if you lose your employer-sponsored health benefits.
How to Enroll
- Watch for the COBRA election notice after your qualifying event
- Elect coverage within 60 days of your notice or loss of coverage
- Make your first payment within 45 days after you elect
- Continue paying each month by the due date to avoid termination
Start Date
Please allow 5-7 business days after payment for enrollment to take effect.
What Coverage Includes
If offered by your employer’s plan, you may continue with medical, dental, and vision coverage. Some plans allow the continuation of Flexible Spending Account (FSA) and Health Reimbursement Arrangement (HRA) balances, subject to the plan’s rules.
How Long Does Coverage Last
Most people can continue coverage for up to 18 months. Certain events may allow extensions in specific situations according to the plan and federal rules.
What COBRA Costs
Expect to pay up to 102 percent of the total monthly premium for the same plan. This amount typically equals the employer portion plus the employee portion, plus a small administrative fee. Use a recent pay stub or plan invoice to estimate the total cost.
For account access or payments, use your New Member Login letter or visit the COBRA login page. For assistance with your account or to make a payment, please contact our support team.
Please refer to your State’s Health Insurance Exchange if you choose to not elect COBRA through your prior employer
A health insurance exchange is an online marketplace where consumers can compare and buy individual health insurance plans.
https://www.healthinsurance.org/glossary/health-insurance-exchange/