If you or a family member recently left a job with group health insurance you may be able to continue this coverage by paying the full cost of the insurance. This coverage option is named COBRA because of the federal legislation (Consolidated Omnibus Budget Reconciliation Act of 1986) that established the extension of employer-based coverage.
You also may be able to get insurance through NY State of Health and qualify for a tax credit to lower your insurance costs.
If you work in the entertainment industry, you may also qualify for state assistance to lower your COBRA costs .
But you have a limited amount of time to make these decisions.
COBRA is offered to individuals who experience a voluntary or involuntary separation from an employer with 20 or more employees that maintains a group health plan. New York State law also requires smaller employers (those with 2-19 employees) to provide continuation of group coverage to qualifying individuals,
Under both federal and NY State law, your employer or benefits administrator must inform you of your right to continue coverage. Continuation of coverage is also available for family members of employees who qualify because of death, divorce, and other life events. Individuals and families opting for continuation of coverage under federal or New York State law must elect coverage within a specified time period (normally 60 days after receiving notice of COBRA eligibility) and pay the applicable premium.
The length of time that a person may have COBRA coverage depends on why the person is losing coverage and can be from 18 to 36 months.
If you choose to get COBRA coverage, you must pay the full premium amount. A small administrative fee is also allowed, bringing the total premium cost to 102% of the cost of coverage under the employer's group health plan.
Many employees are not aware of how much employers pay in monthly premiums for individual and family coverage of their employees. Since COBRA requires you to pay the full price of coverage, it usually costs much more
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NY State of Health instead of COBRA
If you decide not to take COBRA and you cannot get coverage through another family member’s job-based coverage, you can apply for insurance in NY State of Health. Because the loss of job-based health insurance is considered a qualifying event, you are entitled to a special enrollment period. That means you do not have to wait until the next open enrollment period to seek coverage in or out of NY State of Health. This special enrollment period is only available for 60 days, so you must apply quickly.
You may pay less for health insurance in NY State of Health than you would for COBRA . especially if you have experienced a loss of income.
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State assistance for entertainment workers
New York State residents working in the entertainment industry may be able to reduce their COBRA costs by accessing premium subsidy support under the State's Health Insurance Continuation Assistance Demonstration Program.
If you are an entertainment industry employee in New York State and eligible for or already covered by COBRA, the New York State Department of Financial Services may pay 50 percent of your COBRA premium costs for up to 12 months.
To be eligible, you must meet all of the following requirements:
- You must be a resident of New York State.
- You must be eligible for, or already covered by, COBRA/continuation coverage through a collectively bargained plan covering entertainment industry employees.
- You must not already be receiving continuation assistance through a New York State Department of Health program.
- You must not be eligible for Medicare.
- You must not be eligible for employer sponsored coverage.
- You must meet the household income limitation set by federal law.
For current income guidelines and more information about this program, please visit the New York State Department of Financial Services: Continuation Assistance Demonstration Program for Entertainment Industry Employees
For more information on your health care options under COBRA, contact your employer or the following:
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