COBRA Makes Keeping Your Coverage Convenient, But Not Necessarily Economical
If you lose or quit your job, get a divorce, or age out of your parent’s health insurance, you may be eligible for COBRA, or the Consolidated Omnibus Budget Reconciliation Act. COBRA allows you to keep the same employer-sponsored health plan you had before your job loss or divorce. But being eligible for COBRA doesn’t necessarily mean you can afford it.
A 2016 Kaiser Family Foundation analysis indicated that employers pay an average of nearly 82 percent of the cost of their employees’ health insurance, and nearly 70 percent of the total family premium for employees who add family members to their coverage.
To determine your COBRA premiums, you’ll have to add what your employer has been contributing toward your premiums to what you’ve been paying in premiums, and then add the 2 percent service charge.
Let’s say you have $125 taken from each paycheck for health insurance. You get paid twice per month, so your portion of the monthly premiums is $250. Your employer contributes $400 per month toward your health insurance premiums, so the total cost of your job-based health plan is $650 per month.
Your employee benefits or human resources office can tell you how much your COBRA premiums would be, but there may be circumstances under which you want to figure it out without alerting your employer to the fact that you’re considering leaving your job.
However, if you’re switching from a job-based family plan to COBRA single coverage, for example, because you’re getting divorced or aging off of your parent’s plan, it will be more difficult to calculate the premiums this way yourself because you’re not comparing apples to apples. In this case, you’ll want to ask your employee benefits office or human resources office how much your COBRA premiums will be after accounting for your changing family status.
For example, let’s say you’re currently enrolled in a family plan through your spouse’s employer. You’re getting a divorce, so you need to switch to COBRA for a single person since your spouse will continue to cover the kids. The employee benefits officer will look up the health insurance premium for the same health plan you have now, but using the rates for a single individual rather than for a family. He or she will then add what the company would have been contributing toward that premium, what the single individual would have been contributing toward that premium (this would have been your portion of the payroll deduction that your spouse was paying for the family plan), and the 2 percent service charge, to get your premium for COBRA coverage with that health plan as a single person.
Another Reason for Sticker Shock
As if the sticker shock associated with paying both the employee’s portion and the employer’s portion of the health plan premium isn’t enough, there’s another financial hit lurking in the background with COBRA: income taxes.
When your employer takes money from each of your paychecks to pay your part of the health insurance premium, that money is taken out of your paycheck before your income taxes are figured. Similar to contributions to your 401(k) retirement plan, health plan premiums taken from your paycheck pre-tax make your income look smaller. The smaller your income looks, the lower your income taxes will be.
When you lose access to your job-based coverage and switch to COBRA coverage, you pay your COBRA premiums with after-tax money. That means you lose the tax-free benefit of the premiums being deducted from your paycheck pre-tax.
In some cases, you may be able to compensate for this tax hit by deducting part or all of your COBRA premiums, but not everybody is eligible for this deduction. To learn more about who can take a tax deduction for health insurance premiums, see “Is Health Insurance Tax Deductible?”
Are There Other Alternatives?
The individual health insurance market has always been an alternative to COBRA. Historically, individual market plans were less expensive than COBRA, but the catch was that coverage was only available to people who could pass medical underwriting, which meant they had to be reasonably healthy. People with pre-existing conditions often didn’t have a realistic alternative to COBRA.
Your employer will send you a notification letting you know that you’re eligible for COBRA, how much it will cost, and informing you that you’ve got 60 days to decide whether to continue your health plan with COBRA. During that time, you can compare the price and coverage available to you in the individual market, and decide which one presents a better value.Your special enrollment period in the individual market continues for a full 60 days after you would otherwise lose access to your employer’s plan, even if you elect COBRA early in that window. That means you can still change your mind and switch to an individual market plan, even if you signed up for COBRA without fully understanding the available options.The Basics of Major Medical Health Insurance
Where Can I Get More Information About COBRA?
A Word From Verywell
If you’re losing access to an employer-sponsored plan that has worked well for you, it’s reassuring to know that in many cases, COBRA gives you the option to purchase that plan for at least 18 months. But since that can be an expensive proposition, it’s also good to understand the options available in the individual market, so that you can make the best choice for yourself and your family.