To be considered a qualified beneficiary, you must be insured by the health plan the day before the qualifying event happens. In addition, you must be one of the following:

• An employee of the employer sponsoring the health plan.
• A spouse or ex-spouse of that employee.
• A dependent of that employee.
• An agent, director, or independent contractor that isn’t technically an employee, but that participates in the health plan.
• In some cases, you may be eligible if you’re a retired employee, retiree’s spouse, or retiree’s dependent child and you’re losing coverage because your former employer is going bankrupt.

What qualifies as a life event depends on whether you’re the employee losing coverage, or a spouse or dependent of that employee. Your life-event will qualify you for COBRA coverage if you’re the employee and:

• You’re laid off.
• You quit.
• You’re fired, but not for gross misconduct like stealing or assaulting the boss.
• Your employment is terminated for any other reason.
• You’re still employed, but your hours are reduced to a level that causes you to lose your health insurance benefit (this can be a voluntary change in hours that you request, or a change that’s imposed on you by your employer; either way, you’d be eligible to continue your coverage with COBRA).

Your life-event will qualify you for COBRA coverage if you’re the spouse or dependent of the covered employee and you’re losing coverage because:

• One of the above things happened to the employee.
• The employee is becoming eligible for Medicare. If this is your situation, discover your options about losing your health your health insurance because your spouse is getting medicare?
• The employee died.
• You’re getting divorced or legally separated from the employee.
• You’re a young adult and you’re losing your dependent status with the health plan. If this is your situation, discover your options about turning 26 & getting kicked off your parent’s health insurance.

If you have the option to continue your health plan with COBRA, you don’t have to decide right away. You’ll have a 60-day window during which you can sign up for COBRA (it starts on the day you get the COBRA notification, or the day that your employer-sponsored coverage would otherwise end—whichever is later).

Keep in mind once your COBRA election window closes, it can’t be reopened. And if you miss your special enrollment period for individual market coverage, you’d have to wait for the next annual open enrollment period, which is usual November 1 to December 15 in most states.

Cosmo Insurance Agency is an independent insurance agency serving surrounding communities in New Jersey. Cosmo keeps its promise to assure an efficient and creative approach to the services we offer. Each of our clients experience a personalized and long-term relationship with us. Our New Jersey based team of health brokers guides our clients in helping them choose the most cost-effective options. By incorporating the latest in technology-based tools and laws on healthcare, employee benefits, life insurance and finance, we keep our clients up-to-date with the plans that encompass all of their needs, whether it is individual or group insurance. 

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