After being fired in December from her job as a systems analyst for a specialty chemicals company, Gabriella De Pompeignon opted to hang onto her former employer’s insurance coverage under a federal law called COBRA. Typically, laid-off workers bear the total cost of premiums under COBRA, but their company paid about 75% of the expenses for the first six months, leaving de Pompeignon with a $659 monthly bill for the family plan, In which she, her husband and their 9-year-old son.
Since de Pompeignon and her husband, a lawyer, were unemployed, their company’s temporary financial support was key to making their premiums affordable. What De Pompeignon didn’t realize, however, was that she deserved an even better deal. Under the American Rescue Plan Act, which was signed by President Joe Biden in March, there are COBRA premiums for laid-off workers. fully covered by federal funding for six months from April to September.
Neither her former employer nor the company administering COBRA benefits for her workplace told her of that option.
Under federal rules, he should have been sent a notice Informing him by May 31 of the subsidy, which is generally available to those who were involuntarily laid off or whose hours were reduced and who are eligible for continued employer coverage under COBRA .
For people like De Pompeignon who lost their jobs before April 1, the window to take advantage of subsidized coverage is closing. They have 60 days from the date their employer notified them of the COBRA subsidy to sign up – that is, July 31 if their employer notified them at the end of May. The people informed earlier may have already missed their opportunity.
People can sign up for a subsidy even if they have not previously opted for COBRA coverage, or if they have previously had COBRA and give it up because it was too expensive or for some other reason.
People fired or on leave after April 1 have 60 days to sign up for regular COBRA coverage and temporary financial assistance.
De Pompeignon learned of the subsidy only because he happened upon a news story that described it.
“I don’t know their reasons for not telling us about this option,” said Dee Pompignon, 45, who lives with her family in Mendham, New Jersey. “But I was disappointed.” He added that many workers who have been laid off “may struggle to pay their health insurance during such difficult times.”
In a statement to KHN, Troian Group, the company that manages its former employer’s COBRA coverage, said, “As COBRA administrators, we rely on our customers to provide us with information about which of their Ex-employees are eligible for ARPA subsidy. Once we were notified of the error in Ms. De Pompeignon’s initial status, we immediately changed our system and sent her an eligibility notification.
Consumer advocates say they are concerned that many more may have been left in the dark about the subsidies because the need to send notices to former employees was not until the end of May, two months after the benefits began.
“Even if everyone got the notices on time, are people reading them and understanding what they deserve and what their options are?” Katie Keith, associate research professor at Georgetown University’s Center on Health Insurance Reforms.
Karen Politz, a senior partner at KFF, said she spoke with some who were notified immediately, while others were not notified of the subsidy until the end of May and were asked to pay the first two months of subsidized premiums. was to be reimbursed. (KHN is an editorially independent program of the KFF.)
The Labor Department said it has “conducted extensive outreach and education to promote awareness of the premium assistance available” to help workers and employers.
According to labor officials, outreach includes virtual webcasts and webinars, social media, radio and TV public service announcements, billboards and posters. He said consumers or employers can ask questions contact the department online or by phone.
under federal cobra lawUsually, people can choose to continue their employer’s health coverage for 18 months after being fired. They usually have 60 days to decide, although that deadline has been extended while the pandemic continues. The law applies to employers with 20 or more employees.
However, without special federal subsidies, it is a valuable gain: Usually people are responsible for the entire premium plus 2% administrative fee.
People who work in smaller companies — those with fewer than 20 employees — that are located in states that have so-called mini-COBRA coverage continuation laws can also take advantage of subsidies. But there’s a catch: To qualify, workers typically must elect COBRA continuation coverage before April 1 or become eligible after.
Getting the word out was interrupted due to the program’s short deadline. Experts said it was challenging for employers to ascertain who was eligible for the subsidy and to receive notices in such a short span of time. The law passed in March, and guidance from the Department of Labor and the IRS about enforcing the law came in April and May. The notice was to be given to the employees on 31 May.
“I think employers were working round the clock to make sure the notices went out,” said Katy Johnson, senior attorney for health policy at the American Benefits Council.
But as De Pompignon’s experience shows, some slipped through the cracks.
With his employer’s subsidies ending in June, De Pompeignon called the service center at Troian Group to find out what his coverage options were. The representative who answered the phone suggested that De Pompeignon look into plans to market.
After De Pompeignon saw the news about the COBRA subsidy, he contacted his former employer to ask if he was eligible. The answer was yes, she probably was. Only then did he get the paperwork.
De Pompignon, who paid her share of the COBRA premiums for April, May and June, said she has been assured that she will be reimbursed.
Because De Pompeignon’s job loss was initially incorrectly coded as “voluntary” by his employer, Infinum, “[it] The Troian system caused him to be excluded from communications regarding federal subsidies,” according to Hedi DiSimoni, human resources benefits and payroll leader at Infinum. de Pompeignon for the first three months of premiums paid before being notified Will receive a refund, Dissimoni said.
After the subsidies ended in September, de Pompignon said, she isn’t sure what her family will do if she and her husband are still unemployed.
They can continue their COBRA coverage by paying the full premium. They will also have the opportunity to sign up for coverage in the state’s marketplace, under a special enrollment period.
For some people, marketplace coverage may be a better option.
Any person who has received unemployment insurance benefits for even one week this year can get silver level plan Without premiums and with cost-sharing assistance, that can dramatically reduce their out-of-pocket costs, said Sabrina Corlett, a research professor at Georgetown University’s Center on Health Insurance Reforms.
“It will probably have a lower deductible than the COBRA plan, and it doesn’t stop after September,” Corlett said.
KHN (Kaiser Health News) is a national newsroom that conducts in-depth journalism about health issues. Along with policy analysis and polling, KHN is one of three major operational programs. kff (Kaiser Family Foundation). KFF is a thriving non-profit organization that provides information on health issues to the nation.