New York Expands COBRA Coverage
Governor David A. Paterson signed into law three Governor’s Program bills that will make health insurance more affordable and improve access to health care for New Yorkers. The first extends the period of time for COBRA coverage from 18 to 36 months; the second permits families to cover their young adult dependents through age 29 under their job-based insurance; and the third enacts a series of managed care reforms to make health insurance work better for consumers and permit timely access to necessary health services.
In response to inquiries we have received about the COBRA extensions, the following summary aims to clarify new law and its applicability to New York Mini-COBRA and Federal COBRA.
Summary
The law does extend New York Mini-COBRA from 18 to 36-month. However, it does not extend the 18-month Federal COBRA period, automatically. The law indicates, with respect to Federal COBRA, that insurers will be responsible for providing additional 18-months of state continuation coverage when the COBRA continuant exhausts the federally mandated 18-months of coverage.
The New York law (Senate Bill 5471) is an insurance law addressing continuation of coverage in New York, only. The bill appears to accomplish two goals. First, it expands existing New York mini-COBRA requirements, and second, it requires insurers to provide enhanced continuation coverage opportunities to certain individuals who exhaust federal COBRA continuation coverage benefits.
New York Mini-COBRA
Continuation coverage under New York mini-COBRA is extended from 18 months to 36 months for individuals who are entitled to mini-COBRA as a result of a termination of employment.
We are preparing a New York mini-COBRA qualifying event letter that our systems will employ whenever a client, who meets the New York Mini-COBRA requirements, initiates a COBRA Qualifying Event Notice in our system.
Federal COBRA
A new state continuation coverage opportunity will be available for individuals who were entitled to less than 36 months of federal COBRA continuation coverage benefits and have exhausted those benefits. Coverage may be extended for up to 36 months from the date an individual’s continuation coverage began.
This new law is a state insurance law, so it will only apply to plans insured in the state of New York and not exempt from state insurance law requirements. It applies to insurance policies issued, renewed, modified, altered or amended after July 1, 2009. This means that the extension will not be immediately required for every plan, but calendar year renewals will be subject to the state requirements beginning January 1, 2010.
The new law appears to require the insurer (i.e., the group policy, contract or HMO) to “offer” the insured the extension of coverage. The obligation does not appear to fall on the employer or its COBRA service agent.
We expect more guidance on this law will be forthcoming and, upon our receipt of this information, will alert you accordingly.
We will be requesting our COBRA service clients to identify the State in which their policies were issued and such policies’ annual renewal dates, so we can
maintain this information to optimally process and manage your COBRA accounts. We expect this request to be sent out within the next 5-7 business days.
“Visualize” the Difference between NY Mini-COBRA and Federal COBRA
Under the new NY law, continuation coverage looks like this:
NY Mini-COBRA = 36-Months of continuation coverage
Federal COBRA = 18-Months Federally Mandated + 18 Months of NY Continuation Coverage
Remember:
NY is not modifying the Federal COBRA requirement. Rather, it is adding its own requirement following the exhaustion of Federal COBRA duration of 18-months.
An analogy would be Medicare with a Medicare Supplement. A Medicare Supplement does not amend Medicare coverage. Rather, the Medicare Supplement begins providing coverage after Medicare runs out. Thus, NY COBRA extension for Federal COBRA does not modify Federal COBRA; rather, it provides an extension to the Federal COBRA.
Questions?
If you have any questions about this information, please contact us Monday through Friday from 8:30 a.m. to 5:00 p.m. except Federal
holidays.
Email: info@CobraControl.com Tel: (888) 887-6187
The information contained herein is for informational purposes only and is not intended as legal advice, nor is it intended to advise you of your obligations
under ERISA, COBRA, HIPAA or the American Recovery and Reinvestment Act of 2009.
Filed under: COBRA, New York COBRA
Does this apply to self-insured plans as well as insured plans in NY?
Does the extension of cobra for empire blue cross of new york plans apply to people that have cobra under a new york employer but reside in the state of illinois?
Dear Sir or Madam: My husband’s former employer failed to send any notice to us relative to the NY mini COBRA extension. I discovered the law and wrote them about the extension. Now they are claiming that we are not covered since our Federal COBRA ends on 12/27/09 and their contract with Aetna (Aetna was also the prior insurer) starts on 1/1/10. I called the Governor’s office and they indicated that we should be covered. Could you advise.
I worry about the Healthcare Law. Will it create dehabilitating reprocussions to my expenses? Will the pros overshadow the bad aspects?
Thank you for your post. Only time will tell what type of health care reform comes out of Congress and ultimately becomes law.
Thank you for your post; however, we can not provide legal advice.
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