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With so many different and emerging health insurance provisions, it can be challenging to keep up with what’s available to you, who can help, and what program eligibility requirements apply to you. It used to be that you enrolled in your company’s traditional group health plan and had to abide by in-network and cost parameters.

Today’s companies have more options, as do individuals looking for health insurance coverage and benefits.

More specifically, the ACA plans available via the Marketplace are becoming more popular among individuals. And with the old stand-by options, including COBRA (Consolidated Omnibus Budget Reconciliation Act,) there’s practically an affordable coverage option for everyone. To help you understand how the ACA plans and COBRA coverage work together, here’s everything you should consider, especially if you’ve recently lost your job and need to make a decision about health insurance.

Understanding How COBRA Works

COBRA allows employees to keep their employer-sponsored health insurance even after termination of employment. COBRA recipients will be responsible for paying 100% of the monthly premiums, which can often be costly.

Who COBRA Coverage Is Intended to Help

Spouses and dependents originally provided for under the employer’s plan will remain covered under COBRA. And because you’re extending the same plan, you don’t have to worry about changing doctors or finding new healthcare providers to remain in-network.

COBRA Coverage Benefits and Costs

If you become eligible for COBRA, you’ll be allocated an election period of at least 60 days to make your final determination decision. And once you select COBRA coverage, it will be retroactive to ensure you don’t have any gaps in coverage. The out-of-pocket cost for coverage will vary, depending on the type of plan your employer has in place. There will be a 2% COBRA administrative fee to consider, as well. On average, single coverage costs in 2019 were a little over $7,000 per year. The average family plan premiums back then were $20,599 annually.

ACA Plans Offer Benefits for Nearly Every Individual Need

Today’s ACA plans via the Marketplace provide a host of coverage options for anyone losing their job and facing a decision about health insurance coverage. With the federal subsidies in place, the premiums, and the metal tiers of plans, the options and price points seem endless. Many of the big-name insurance providers offer an ACA plan, making it easier than ever to find the perfect coverage for you.

The ACA Marketplace Advantages

There are several advantages to the more robust ACA Marketplace options today. With various tiers, including bronze, silver, gold, and platinum levels of coverage and associated costs, affordable coverage is easy to find. The premium tax credits, available to applicants based on their household income, can offset the out-of-pocket costs of premiums, providing the greatest advantage. And the variety of plans provides a host of options so people can find just the right coverage based on the in-network status of their preferred healthcare providers.

ACA Plan Benefits and Flexibility

There is added flexibility with ACA plans that you might not find with traditional plans. Because the Marketplace is federally regulated, there are certain guarantees enrollees can expect, including a full roster of essential health benefits coverages like ambulatory care, emergency room visits, hospitalizations, substance abuse services, prescriptions, rehab services, labs, preventive care, chronic disease management, pediatric care, vision, and oral health.

How COBRA Coverage and ACA Plans Complement Each Other

With job security a constant worry for many Americans, it’s nice to know there are plenty of options should job loss become a reality. If you’re facing a termination or layoff, you can look to COBRA or ACA plans for the continuing coverage you need.

More Options with COBRA Coverage and ACA Plans

Every individual will have different needs for healthcare-related services, preferred care providers, and affordability. Losing your job won’t mean you have to forgo quality health insurance coverage. Whether you opt to stay with the coverage you had with your employer via COBRA or choose to go the ACA plan route, you’ll find just the right solution.

How Individuals Benefit from this Broader Range of Coverage

In general, ACA plans provide a more affordable option for eligible participants. But it doesn’t change any of the COBRA provisions, should you find ideal coverage there instead. And because you have time to make your decision, 60 days to choose COBRA, or 60 days to take advantage of your special enrollment period to select an ACA Marketplace plan, you don’t have to rush your decision.

Pete English

With nearly two decades in health insurance, Pete English’s diverse experience makes him uniquely qualified to help health plans and brokers leverage innovative technology in partnership with W3LL. From growing sales staff by 126% over 4 years at a large health plan, to building his own health insurance brokerage firm with over $7.2MM in annualized premium, Pete has done it all.

(631) 681-4898
PEnglish@w3ll.com

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