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COBRA and Premium Assistance

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COBRA, Age 29 and Continued Coverage Information

The federal Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers who work for employers with 20 or more employees and their families the right to continue to purchase group health insurance for limited periods of time when they would otherwise lose coverage due to certain events. Qualifying events include voluntary or involuntary job loss, reduction in hours, transition between jobs, death, divorce and other life events.

Qualified individuals may be required to pay up to 102% of the premium cost. The length of time that a person may have federal COBRA coverage depends on why the person is losing coverage and can be from 18 to 36 months.

New York State Continuation Coverage

The New York State continuation coverage law resembles the federal COBRA. It applies to employers with fewer than 20 employees and gives workers who work for employers with fewer than 20 employees and their families the right to continue to purchase group health insurance for limited periods of time when they would otherwise lose coverage due to certain events. Qualifying events include voluntary or involuntary job loss, reduction in hours, transition between jobs, death, divorce and other life events. Qualified individuals may be required to pay up to 102% of the premium cost. People eligible for continuation coverage may have up to 36 months of coverage.

Continuation Coverage Extension to 36 Months

New York State continuation coverage also grants people who are eligible for federal COBRA coverage who are not entitled to up to 36 months of coverage under federal law

In 2009 Chapter 236 of the Laws of 2009, improved access to health insurance for New Yorkers by making state continuation coverage (“mini-COBRA”) available for a total of 36 months. Under the law, people eligible for federal COBRA or state continuation coverage may receive a total of 36 months of coverage.

"Age 29" Dependent Coverage Extension

Chapter 240 of the Laws of 2009 extends the availability of health insurance coverage to young adults through the age of 29. The expansion is designed to assist young adults who do not have access to employer-sponsored health insurance.  This law is sometimes referred to as the “Age 29” law, because it permits young adults to continue or obtain coverage under a parent’s policy through the age of 29. The law provides two distinct ways in which coverage may be extended: a “young adult option” and a “make available” option.

Young Adult Option

The “Age 29” law permits eligible young adults through the age of 29 to continue or obtain coverage through a parent’s group policy. Insurers will notify employees of this benefit. Employees or their eligible dependents may then elect the benefit and pay the premium, which cannot be more than 100% of the single premium rate. This benefit It is called the young adult option benefit because it permits eligible young adults to continue their coverage through a parent’s health insurance coverage once they reach the maximum age of dependency under the policy. Young adults may also elect this coverage when they newly meet the eligibility criteria, such as if they lose eligibility for group health insurance coverage.

Make Available Option

Under most individual and group health insurance coverage, a dependent child loses coverage or "ages off" a parent's policy when turning 26 years of age. Insurers that issue a policy or contract that provides coverage for dependent children must make available and, if requested by the policyholder/contract holder, extend coverage to qualifying young adults through age 29 as dependents under family coverage.  It is called the “make-available” requirement because insurers are required to make it available at the request of the group or individual policyholder/contract holder. In the case of insurance through an employer or group, the employer or group decides whether to offer this benefit to employees. The young adult does not get to make this choice.

Assistance for Eligible Entertainment Industry Employees

The Continuation Assistance Demonstration Program for Entertainment Industry Employees is a pilot program created in 2004 to assist eligible entertainment industry employees in maintaining health insurance during episodic employment. It was created to address the unique episodic employment conditions in the entertainment industry.

Enroll in Health Insurance through NY State of Health: The Official Health Plan Marketplace

A qualifying event that makes you eligible to purchase COBRA coverage also makes you eligible to purchase coverage through the New York State of Health (NYSOH).  Through the NYSOH you can quickly compare health plan options and apply for assistance that could lower the cost of your health coverage.  You may also qualify for free or low-cost coverage from Medicaid or Child Health Plus. To learn more about or apply visit the NY State of Health website or call (855) 355-5777.