COBRA & MEDICARE

HRgal

We have an employee who is 78 years old, has used all of her FMLA leave. Is still not back to work, but is talking of retiring. She has been on medicare and our health insurance with our plan as primary coverage. Do we have to offer COBRA if she is on medicare? She has no other dependents on her coverage. We are concerned of her claims on our insurance plan if she COBRA's. We are a small group and typically have to change plans each year to get affordable insurance.

Scott Ruth

Yes, because she is already on Medicare, you must offer COBRA coverage at her
termination of employment. Medicare only cuts off COBRA coverage if the person
first becomes entitled to Medicare after electing COBRA coverage.

Medicare is often the primary payor over COBRA after a termination of
employment. Check your plan document and with your insurance carrier to
determine how these rules apply to the employee involved in this situation.

Scott Ruth
Miller & Martin LLP

sonny

. "Medicare only cuts off COBRA coverage if the person
first becomes entitled to Medicare after electing COBRA coverage:



Employee elected COBRA first. Has now been approved for SSDI. I recall that makes him eligible for Medicare (?) There used to be awaiting period but is it now immeadiate? Also, I am confused..one post makes me think that COBRA is an option as a "gap" type coverage that ee could keep with Medicare, but the above makes me think the award of Medicare automatically cuts off COBRA. Can someone help my befuddled mind? Trying to help ee who has SEVERE dementia and his young daughter who is trying to help him and is more befuddled than I. Thanks in advance

Terry

[font size="1" color="#FF0000"]LAST EDITED ON 09-12-02 AT 01:57PM (CST)[/font][p]I don't know about other states, but in New Jersey your experience does not matter, only age and gender are considered for pricing insurance.

NaeNae55

Really? I have never heard of that. We only see age and gender in life insurance rates. All medical in our state (and I believe surrounding states) are based on experience too.

franfields

Age and gender are considered for individual policies, along with pre-existing conditions.

Past experience is the major determinant, with ages and gender as a secondary factor, in group insurance.

NaeNae55

The whole point of offering COBRA is for employees to be able to continue with what they had while employees, so therefore if she had both your insurance and Medicare, you still must offer her COBRA. Only COBRA participants who become eligible for (and take) Medicare later can lose their COBRA rights.

Remember though, the employee will have to pay the full amount of the COBRA premium plus 2%. She can probably find a good supplemental insurance for much less so you probably have nothing to worry about.