Frequently Asked Questions
What is Continuation of Coverage?
Illinois Continuation Law applies to employers of any size but does not apply to self-insured employers; self-insured health and welfare benefit plans such as union plans or insurance policies or trusts written in other states. There are no specific forms to advise the employee or dependents of their rights to elect coverage.
Go to http://www.ins.state.il.us/HealthInsurance/continueIL.htm
COBRA applies to employer groups with 20 or more employees. There are specific forms that an employer must provide to the employee upon the occurrence of a qualifying event.
What is a qualifying event?
For Employee and Covered Dependents —18 months coverage available upon:
- Reduction in number of hours of employee (i.e. hours result in part-time status, for example, less than 30 hours)
- Voluntary or Involuntary Termination with the exception of gross misconduct by employee
- Employee’s retirement
For Spouse, Former Spouse and Covered Dependents – 36 months available upon:
- Employee’s Eligibility for Medicare
- Divorce or legal separation from employee
- Death of employee
- Parent’s Divorce or legal separation from employee spouse
- Loss of dependency status in accordance with plan policy
For more information go to:http://www.dol.gov/dol/topic/health-plans/cobra.htm
Who Pays? The person electing coverage pays the premium. It is not paid by the employer.
Notification of Rights to Elect Coverage
Group Health Plans must provide written notice to each covered employee and spouse (if any) at the time of commencement of coverage:
- either 90 days from the date on which the covered employee or spouse first becomes covered under the plan or
- the date on which the administrator is required to furnish an election notice to the employee or to his or her spouse or dependent. Go to: http://www.dol.gov/dol/topic/health-plans/cobra.htm
How do state and federal laws interact?
Generally if a state law is inconsistent with COBRA, the law that provides better coverage will likely control. For example, in the case where a spouse is over 55 years of age, Illinois state law extends coverage if elected, up to eligibility for Medicare (age 65), whereas COBRA offers 36 months. To the extent that the same law applies and requires the same type of continuation coverage as COBRA, a plan is not required to offer both state coverage and federal coverage.
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