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Florida COBRA Health Insurance

It is important to understand your Florida COBRA health insurance options. Congress passed COBRA, an acronym for the Consolidated Omnibus Budget Reconciliation Act in 1985. When passed in 1985, COBRA amended the Employee Retirement Income Security Act (ERISA), the Internal Revenue Code and the Public Health Service Act to provide continuation of group health insurance coverage that otherwise would be terminated for Florida residents.

When Is Florida COBRA Health Insurance Offered?

In COBRA, provisions are given that allow certain former employees, retirees, spouses and dependent children the right to temporary continuation of health coverage at group rates (up to a maximum rate charge of 102%). This coverage, however, is only available in specific instances. These instances include:

  • involuntary loss of employment (lay off, downsizing, terminated for any reason other than gross misconduct)
  • voluntary termination of employment (you quit)
  • marital separation or divorce
  • if you were a dependent on your guardian/parent’s policy, and you become ineligible (no longer dependent), due to age or no longer attending college
  • if your spouse (who is the employee with the insurance coverage) dies

How Much Does Florida COBRA Health Insurance Cost?

Florida group health coverage for COBRA participants is usually more expensive than health coverage for active employees, since usually the employer formerly paid a part of the premium. Florida COBRA health insurance is also much more expensive than Florida individual health insurance coverage. The law generally covers FL group health plans maintained by employers with 20 or more employees in the prior year. It applies to plans in the private sector and those sponsored by state and local governments. The law does not, however, apply to plans sponsored by the Federal government and certain church- related organizations.

What Types Of Plans Have To Comply With Florida COBRA Health Insurance Laws?

FL group health plans sponsored by private sector employers generally are welfare benefit plans governed by ERISA and subject to its requirements for reporting and disclosure, fiduciary standards and enforcement. ERISA neither establishes minimum standards or benefit eligibility for welfare plans nor mandates the type or level of benefits offered to plan participants. It does, though, require that these plans have rules outlining how workers become entitled to benefits.

In COBRA, a group health plan ordinarily is defined as a plan that provides medical benefits for the employer’s own employees and their dependents through insurance or otherwise (such as a trust, health maintenance organization, self-funded pay-as-you-go basis, reimbursement or combination of these). Medical benefits provided under the terms of the plan and available to COBRA Florida beneficiaries may include:

* Inpatient and outpatient hospital care
* Physician care
* Surgery and other major medical benefits
* Prescription drugs
* Other medical benefits, such as dental and vision care
(Life insurance, however, is not a benefit that must be offered to individuals for purposes of health continuation coverage).

Which Employers Are Required To Comply With Florida COBRA Health Insurance Laws?

Florida group health insurance plans for employers with 20 or more employees on at least 50 percent of the working days in the previous calendar year are subject to COBRA. “Employees” include full-time and part-time workers, agents, independent contractors and directors, and certain self-employed individuals eligible to participate in a group health plan. In order to qualify for COBRA, an individual must be a qualified beneficiary.

What Is The Florida COBRA Definition Of A “Qualified Beneficiary”?

A qualified beneficiary generally is any individual covered by a group health plan on the day before a qualifying event. A qualified beneficiary may be an employee, the employee’s spouse and dependent children, and in certain cases, a retired employee, the retired employee’s spouse and dependent children. “Qualifying events” are certain types of events that would cause, except for COBRA continuation coverage, an individual to lose health coverage. The type of qualifying event will determine who the qualified beneficiaries are and the required amount of time that a plan must offer the health coverage to them under COBRA. A plan, at its discretion, may provide longer periods of continuation coverage.

What Is The Florida COBRA Definition Of A “Qualifying Event”?

The types of qualifying events for Florida employees are:

* Voluntary or involuntary termination of employment for reasons other than “gross misconduct”
* Reduction in the number of hours of employment

The types of qualifying events for spouses are:

* Termination of the covered employee’s employment for any reason other than “gross misconduct”
* Reduction in the hours worked by the covered employee
* Covered employee’s becoming entitled to Medicare
* Divorce or legal separation of the covered employee
* Death of the covered employee

The types of qualifying events for dependent children are:

*Termination of covered employee’s employment for any reason other than “gross misconduct”
* Reduction in the hours worked by the covered employee
* Loss of “dependent child” status under the plan rules
* Covered employee’s becoming entitled to Medicare
* Divorce or legal separation of the covered employee

How Long Does Florida COBRA Health Insurance Coverage Last?

While there are many different qualifying events, the time frame for coverage can be anywhere from 18-36 months (and in some rare cases up to 39 months or more depending on certain disability criteria), depending on the circumstance. In Florida, The Florida Health Insurance Coverage Continuation Act requires insurance companies to offer an 18-month continuation for groups of 2-19. However, the employee must request the extension within 30 days of termination.

Florida COBRA Health Insurance Summary

COBRA is an acronym, which stands for Consolidated Omnibus Budget Reconciliation Act of 1985. Under this federal law, as a Florida resident, you are provided with a back-up system in a time of need, when you aren’t currently covered by insurance for a variety of reasons.

To qualify for a Florida COBRA health insurance plan you must be a qualified beneficiary, which is defined as an individual covered by a group health plan on the day before a qualifying event. A qualifying event is a circumstance that causes involuntary loss of employment, voluntary termination of employment, marital separation or divorce, aging out of dependency, or the death of a covered spouse.

The Florida COBRA health insurance laws (along with the Florida HIPAA health insurance laws) make it all the more important to maintain continuous health insurance coverage so that you do not disqualify yourself and become ineligible for COBRA and HIPAA benefits.

Compare Florida Health Insurance Quotes Now!

Keep in mind that if you are somewhat healthy then it is almost always better to purchase an individual health insurance plan on the open market. Florida individual health insurance plans will be approximately half the cost of a Florida group health insurance plan with similar benefits.

Use our free FL health quote finder to compare rates from multiple insurers side by side.

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