65% of COBRA subsidized by Stimulus

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Peety
Veteran Member


Date Joined Mar 2008
Total Posts : 2855
   Posted 2/20/2009 4:11 PM (GMT -6)   
I took this from an online source and can't guarantee its accuracy but it's consistent with all else I've read. I hope it helps those of you in this situation.
 

·         The government will provide a 65% subsidy for up to 9 months of the COBRA premium effective March 1, 2009 for certain terminated employees.

·         Employees entitled to the subsidy must have been involuntarily terminated (for reasons other than gross misconduct) between September 1, 2008 and December 31, 2009 and must be eligible for COBRA.

·         A special election period exists for individuals involuntarily terminated on or after September 1, 2008 who had not elected COBRA; they will have an additional time period to do so as discussed below.

·         The subsidy is not retroactive, but will continue for a period of up to 9 months beginning on or after March 1, 2009.

·         The subsidy terminates at the earlier of (a) 9 months; (b) eligibility for other employer health coverage; (c) Medicare eligibility; (d) the end of the maximum COBRA coverage period required by law; or (e) for those electing COBRA during the special election period, the end of the COBRA period starting from the initial time period when the employee could have elected COBRA. 

·         The employer pays the 65% on the employee's behalf and is then reimbursed.

·         The employee (or someone other than the employer) must pay 35% of COBRA before the employer can request reimbursement of the other 65%; employers who do not charge the full COBRA premium will not be entitled to reimbursement of 65% of the maximum COBRA premium.

·         The subsidy is phased out through additional taxation for taxpayers with an adjusted gross income of more than $125,000 (or $250,000 if married filing jointly). Additional taxation is imposed and is capped by the full amount of the subsidy for taxpayers whose modified adjusted gross income meets $145,000 (or $290,000 in cases of a joint return).

·         If the employer allows, employees may elect coverage different than that in effect at the time of termination... [there were lots more details about this that I'll not include here]


49 year old female attorney, diagnosed UC/pancolitis 1985, no surgery but much suffering.
Asacol/5ASA 6x400 mg maintenance for 20+ years; use prednisone & Rowasa for flares. 
August 2008 sought care of naturopathic doctor. Food sensitivity test showed wheat/gluten, other intolerances; started diet without gluten, soy, dairy, tomato etc. Probiotics (Ultimate Flora, 50 billion). Doing much better, but still having some bad days. 


mtgman
Veteran Member


Date Joined Mar 2005
Total Posts : 1289
   Posted 2/20/2009 8:18 PM (GMT -6)   
this is HUGE...i just turned in my cobra paperwork two days ago after being laid off! I'm 100% against this "stimulus" package, but the COBRA issue directly impacts me and is a good eay to keep money directly in peoples' pockets!! At least they got one part of it right!!!!!!!

FitzyK23
Veteran Member


Date Joined May 2005
Total Posts : 4219
   Posted 2/20/2009 9:12 PM (GMT -6)   
Great news! Thanks for posting!
27 Year old married female law student (last year!!). Diagnosed w/ CD 4 years ago, IBS for over 10 years before that, which was probably the CD. I am sort of lactose intollerant too but can handle anything cultured and do well w/ lactose pills and lactaid. For crohns I am currently on Pentasa 4 pills/4x day and hysociamine prn. I also have bad acid reflux and have been on PPI's since age 13. I have been through prilosec, prevacid, and nexium. Currently I am on Protonix in the morning and Zantac at night. I also take a birth control pill to allow some fun in my life.


subdued
Veteran Member


Date Joined Dec 2008
Total Posts : 3231
   Posted 2/21/2009 1:39 AM (GMT -6)   
I was laid off last Dec. 12. I'm now working again, only as a contractor, not an employee. I filled out my Cobra papers only just recently. Do I still qualify for Cobra benefits now that I'm working again, or do I need to switch to private insurance?
Joy - 47 yrs and counting
Diagnosed w/ UC Dec 06 (also have IBS)
Currently in remission

Lexapro (for stress)
Probiotics and Vitamins (a whole bunch of them)
Anti-inflammatory foods: turmeric, seaweed, garlic...
Avoid: anything with high-fructose corn syrup, foods high in fructose, artificial sweeteners
Previous treatments: Fecal transplantation (worked), Prednisone (stopped working), Colazal (stopped working), Asacol (stopped working)


JM21204
Regular Member


Date Joined Dec 2008
Total Posts : 254
   Posted 2/21/2009 7:03 AM (GMT -6)   
My husband and I are both fully employed thank goodness, but we're currently on his insurance. Reliable rumor has it my husband's company is having layoffs in early March and according to my husband you can't add dependents after you start COBRA. Anyone know if that's true? I'm getting induced on 3/10 and thank goodness it is an option I have, but the last thing I want to be doing is trying to get our insurance changed over to my employer while I'm in the midst of delivering a baby. Also, do I read correctly that there is a maximum income level taper on being only partially eligible and/or not eligible at all?
34 yr old female
Diagnosed with Pancolitis in 1/2007
Baby due 3/2009
Meds:1600 mg Asacol a day, Ferrex, Pre-Natal Vitamins, Lovenox, on and off Prednisone (40 mg then taper)
 


Peety
Veteran Member


Date Joined Mar 2008
Total Posts : 2855
   Posted 2/21/2009 12:14 PM (GMT -6)   
I'm sorry, I don't have the answers to these questions. Try the employer first, but if you don't have (or don't trust) an expert at the employer to turn to, call your Member of Congress in D.C., you can find the numbers on their websites. And if they don't have someone in their office who knows the details, they should still be able to tell you where you can get answers.

My husband was eligible for extended unemployment benefits but could not get through the busy phone lines, after trying for weeks and weeks. One pleading -- not angry -- call to the Governor's office and all was taken care of in a matter of hours. By then he had almost $5,000 in benefits he was owed that he finally got.


49 year old female attorney, diagnosed UC/pancolitis 1985, no surgery but much suffering.
Asacol/5ASA 6x400 mg maintenance for 20+ years; use prednisone & Rowasa for flares. 
August 2008 sought care of naturopathic doctor. Food sensitivity test showed wheat/gluten, other intolerances; started diet without gluten, soy, dairy, tomato etc. Probiotics (Ultimate Flora, 50 billion). Doing much better, but still having some bad days. 

Post Edited (Peety) : 2/21/2009 10:17:03 AM (GMT-7)


Peety
Veteran Member


Date Joined Mar 2008
Total Posts : 2855
   Posted 2/27/2009 3:37 PM (GMT -6)   
A new twist: If your employer is not required to provide Cobra (like some nonprofits or church-related organizations or really small business) but still offers a Cobra-type program, you cannot get the 65% subsidy.

My employer is in that position. They are considering whether they should increase their contribution to the (self-insured) Cobra-type benefit so it has the same effective discount employees are getting if they worked for companies that have to offer COBRA. Nice to work for a company that recognizes the right thing to do in these circumstances.
49 year old female attorney, diagnosed UC/pancolitis 1985, no surgery but much suffering. Asacol/5ASA 6x400 mg maintenance for 20+ years; use prednisone & Rowasa for flares. 
August 2008 sought care of naturopathic doctor. Food sensitivity test showed wheat/gluten, other intolerances; eliminated all wheat/gluten from my diet. Probiotics (Ultimate Flora, 50 billion), trying Curamin. 
Flaring, seasonal? or supplements too harsh? Back on prednisone, trying 15/20 mg. Appt 3/6 to discuss Humira, etc.   


Mtnhawk
New Member


Date Joined Feb 2009
Total Posts : 16
   Posted 2/27/2009 5:13 PM (GMT -6)   
I am on cobra with United Health care and what a pain in the butt to make payments. Now I will have another lapse in coverage with the next month. They are so hard to work with. Yes the Gov. will pick up 65% but I still had to pay full premium until they figure it out. This is just making me worse.

bbc
Veteran Member


Date Joined Mar 2008
Total Posts : 1580
   Posted 2/27/2009 7:06 PM (GMT -6)   
Mtnhawk...please keep us posted on how to best deal with UHC.

Peety...Thanks for the info as I know someone who can really benefit from this.
 
If someone got laid off during this period and was on Cobra from a previous/another employeer who she left to pursue a new job that she just got laid off from; will this still be covered?


Moderate Pancolitis
Dx'd 05/2007
8 Pentasa per day (4/2)
Corti Foam p.m. 3X per week and canasa every other day
Natural anti fungal, anti inflammation supplements and Probiotics.
Bowel Soother and IntestiNew, Fish Oil, Calcium, Multi Vitamin and Melatonin
Eliminated Fructose and Corn Syrup
Reduced sugar in my diet by at least 70%
Reduced wheat products by 70% 
Could never tolerate artificial sweetners
I excersice daily (unless like now : (  I've lost too much weight)
Did I happen to mention I HATE this disease!!!
 
*Recent Changes In Blue*

Post Edited (bbc) : 2/27/2009 5:47:55 PM (GMT-7)


nucid
Regular Member


Date Joined Feb 2009
Total Posts : 63
   Posted 2/27/2009 7:09 PM (GMT -6)   
If I remember correctly the birth of a baby is not considered adding a dependent. Usually any insurance coverage you have automatically picks up the baby as soon as it is born. I was on cobra with the birth of my first child. It can be very difficult to switch insurance in the middle of a pregnancy generally it is easier to cobra and switch after the birth.

You can also have a separate insurance company to carry the baby after birth. But I had trouble setting that up without a birth date. My Cobra insurance at the time was horrible. I paid over 75% for that out of pocket. You do want to make sure the baby is covered. You don't want to be concerned about treatments if complications should arise. My daughter was born with extra fluid in her lungs. She was in ICU for two days, on oxygen, and they grew cultures. It was not a big deal, but that can get very expensive quickly.
Female 33 Married
diagnosed January 2009
mild pancolitis
Sulfasalazine 500mg 3X

"The Lord is my Shepherd"

Post Edited (nucid) : 2/27/2009 5:16:04 PM (GMT-7)


Meesh
Veteran Member


Date Joined May 2006
Total Posts : 619
   Posted 2/27/2009 8:22 PM (GMT -6)   
COBRA isn't dependent on you being employed or not employed, once you sign up for it you're good to go for 18 mos, unless they decide to extend that as part of the stimulus. If your new company has insurance bennies you're probably going to want to sign up for them as they'd probably be cheaper than your COBRA payment.

The most important thing for all of us is to make sure that come hell or high water we have no lapse in coverage or it can be almost impossible to get your UC covered. So whatever the cost, keep your COBRA coverage up to date.

The birth of baby is a qualifying event and not "adding a dependent" so baby can't be denied coverage nor be forced to wait for an enrollment period.

A better place to ask all these questions would be your HR person or the insurance company itself, you'll get your situations answers.
46 yr old female, dx'd UC April 27, 2006; mild arthritis in lower back, dx'd May 2008; Osteopenia dx'd 6/08 Finally achieved remission mid October 2008!!

13 Remicade infusions: 1st: 7/21/07; most recent: 1/21/09; Current meds & supplements: Lialda, 4 tabs in the morning; Xanax as needed (rarely); Rowesa and/or Canasa; multivitamin w/folate; Culturelle; Fish oil capsules, calcium chews and/or Tums; Vitamin D;

Past meds: Prednisone 4/06-4/08; Entocourt EC; Asacol; Colazal; Venofer (iron) injections Dec '07; Imuran (extremely bad reaction 2/07); Protonix; Lexipro


WishfulMA
Regular Member


Date Joined Jul 2008
Total Posts : 197
   Posted 2/27/2009 10:32 PM (GMT -6)   

I found this from an employer Association in Massachusetts.....

AIM has received information clarifying some aspects of the American Recovery and Reinvestment Act (ARRA) as it relates to the COBRA premium subsidy program:

The subsidy is available only to employees and dependents who lose coverage due to an involuntary termination of employment – not to those who experience an involuntary reduction of hours that results in loss of coverage.

Unless the Department of Labor (DOL) issues a different interpretation, it appears that any “involuntary” termination results in subsidy eligibility – even those that are for poor performance or attendance, etc. The original COBRA law provides that continuation coverage need not be offered to employees guilty of “gross misconduct,” but many legal experts agree that most discharges do not rise to the level of “gross misconduct” in light of related court decisions.

As we stated in earlier communications, eligibility for the subsidy ceases on the day a qualified beneficiary is eligible for “any other group health plan” (other than some well defined narrow-coverage plans), which means that those who are eligible under a spouse’s or parent’s plan would not be eligible for the subsidy.

The issue of a “termination” raises an interesting issue. The term “layoff” is very often used interchangeably with “termination” – something the HR professionals at AIM frequently discuss with employers. And in many cases what people call a layoff is really a total termination of employment. But some organizations have a true layoff policy/practice where people stop working but remain on payroll for some specified period of time, often with recall rights provided through a union contract or an employer policy. They are not officially terminated until the end of that specified period of time. It is not yet clear exactly how “termination” will be interpreted by the DOL for subsidy eligibility.


severe ulcerative proctitis - march 05 diagnosed
proctosigmoiditis - january 09 diagnosed
hospitalized - 3/08 for 6 days of IV steriods
hospitalized - 1/09 for 5 days of IV steriods / put on 6MP
past meds: colozol, sulfasalzine, hydrocortisone enemas, canasa, rowasa and prednisone 
current meds: 6MP (75mgs), Asacol 12 pills,  Rowasa Enema, Primal Defense Ultra Probiotic, fish oil, calcium w/ vitamin d 2x a day, prenatal vitamin & extra vitamin c and b12.
 
 


jujub
Elite Member


Date Joined Mar 2003
Total Posts : 10407
   Posted 2/28/2009 10:23 AM (GMT -6)   

Here's a link to the Department of Labor's COBRA page:

http://www.dol.gov/ebsa/faqs/faq_consumer_cobra.HTML

It may be able to answer some of your questions.


Judy
 
Moderate to severe left-sided UC (21 cm) diagnosed 2001.
Avascular necrosis in both shoulders is my "forever" gift from Entocort.
Colazal,  Remicade, Nature's Way Primadophilus Reuteri. In remission since April, 2006.
"My life is an ongoing medical adventure"
 
Co-Moderator UC Forum
Please remember to consult your health care provider when making health-related decisions.


mtgman
Veteran Member


Date Joined Mar 2005
Total Posts : 1289
   Posted 3/1/2009 5:42 PM (GMT -6)   
i just read an article saying this 65% subsidy is not going to happen anytime soon...there is way too much confusion about how it's going to work...most emplyers will not be able to roll it out until May or June...

Dr-A
Veteran Member


Date Joined Jul 2006
Total Posts : 2105
   Posted 3/1/2009 6:03 PM (GMT -6)   
I was told by the people (ADP) that I am making my payment to it starts March 1st for everyone. You will get paperwork in the mail. Just told this last week so hopefully it remains true.
Proctitis DX 1999, Pancolitis DX 2008
Lialda 1 day
Immuran
Golimumab study (100mg every 4 weeks)
Vitamin E Enemas as needed
Probiotis/GreenTea/VitD+Ca/SuperDHA


mtgman
Veteran Member


Date Joined Mar 2005
Total Posts : 1289
   Posted 3/1/2009 6:28 PM (GMT -6)   
http://www.foxnews.com/politics/2009/03/01/uncertainty-new-health-safety-net-laid-workers/

here's the link for the article I read...certainly hope it does not take this long!

Dr-A
Veteran Member


Date Joined Jul 2006
Total Posts : 2105
   Posted 3/1/2009 7:57 PM (GMT -6)   
Well that doesn't suprise me.
Proctitis DX 1999, Pancolitis DX 2008
Lialda 1 day
Immuran
Golimumab study (100mg every 4 weeks)
Vitamin E Enemas as needed
Probiotis/GreenTea/VitD+Ca/SuperDHA


mtgman
Veteran Member


Date Joined Mar 2005
Total Posts : 1289
   Posted 3/1/2009 9:38 PM (GMT -6)   
haha no doubt. i didn't think there was a shot in he** this would go smoothly!
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