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How Does the End of the COVID Public Health Emergency Affect COBRA?

The U.S. Department of Health and Human Services (HHS) announced the end of the federal Public Health Emergency (PHE) for COVID-19. The PHE ended on May 11, 2023, and it impacts health insurance in a number of ways. We shared the impact on Medicaid in a previous blog. This blog shares how the end of the COVID-19 public health emergency affects COBRA. 

What is COBRA?

If you are losing your health insurance at work, you may have several options for health insurance. COBRA is one of those options.  COBRA allows you to keep the same health insurance you had at work, for an additional period of time. 

Do I Qualify for COBRA?

COBRA applies to private employers with 20 or more employees, or state or federal governments. COBRA allows employees and their family members to choose to continue their employer-sponsored health insurance, after experiencing a “qualifying event.” Qualifying events can include employment ending, no longer being a dependent child by turning 26, or divorcing a spouse.   

Eligible individuals typically have 60 days to choose COBRA. But they are responsible for paying their COBRA premiums.

During the PHE, people had extra time to choose COBRA and pay the premiums. Now that the PHE has ended, individuals need to make COBRA decisions and pay premiums within 60 days after July 10, 2023, the end of the “outbreak period.” After September 8, 2023, COBRA time frames will return to pre-pandemic timelines.

What are the COBRA Deadlines I Need to Know?

  • The 60-day period for electing COBRA continuation coverage. These 60 days start the date of your qualifying event, or the date you receive a notice from your employer, whichever is later. 
  • The 45-day period to make your first COBRA premium payment, and the 30-day period to make each additional COBRA premium payment; 
  • The 60-day period that employees must notify the plan of a COBRA qualifying event or a determination of disability; and 
  • The plan administrator must provide notice to the employee of the ability to keep their health insurance through COBRA. Typically, they have 44 days from the qualifying event.

Here are some examples showing how the new COBRA deadlines will work after the Outbreak Period ends on July 10, 2023: 

When is the Deadline to Elect COBRA?

Losing employer-sponsored health insurance before the end of the PHE

  • Cameron has health insurance at work. His hours are reduced while in treatment, which caused him to lose health insurance coverage on April 1, 2023. Cameron is eligible for COBRA coverage and got a COBRA election notice on May 1, 2023. What is the deadline for Cameron to choose COBRA?
    • Cameron can elect COBRA by September 8, 2023. This is 60 days after July 10, 2023 (the end of the Outbreak Period).

Losing employer-sponsored health insurance during the Outbreak Period

  • Alice lost her job and health insurance coverage on May 12, 2023. She received a COBRA election notice on May 15, 2023. What is the deadline for Alice to choose COBRA? 
  • Because the qualifying event occurred on May 12, 2023, after the end of the PHE but during the Outbreak Period, the extensions still applied. The last day of Alice’s COBRA election period is September 8, 2023 — 60 days after July 10, 2023 (the end of the Outbreak Period).

Losing employer-sponsored health insurance after the Outbreak Period

  • Ben’s wife was recently let go and she loses health insurance coverage on July 12, 2023. His wife is provided a COBRA election notice on July 15, 2023. What is the deadline for them to make a COBRA decision?  
  • Because the qualifying event occurred after the end of both the PHE and the Outbreak Period, the extensions under the emergency relief notices do not apply. The deadline for Ben and his wife’s COBRA election period is September 13, 2023–60 days after July 15, 2023.

When is the Deadline to Pay COBRA Premiums?

  • Tori had health insurance at work. Her employment ended and she received a COBRA election notice on May 1, 2023. Tori chose COBRA coverage on May 15, 2023. Her coverage would go back to May 1, 2023. When does Tori need to make the first COBRA premium payment and additional monthly COBRA premium payments?
    • Tori has to make her first COBRA payment by August 24, 2023. This date is 45 days after July 10, 2023 (the end of the Outbreak Period). The first COBRA premium payment would include the monthly premium payments for May, June, and July 2023. 
    • The premium payment for August 2023 must be paid by August 30, 2023 (the last day of the 30-day grace period for the August 2023 premium payment). Additional monthly COBRA premium payments would be due the first of each month, subject to a 30-day grace period. 

[adapted from www.dol.gov/agencies/ebsa/about-ebsa/our-activities/resource-center/faqs/aca-part-58]

More Information & Resources?

If you are losing health insurance at work, check out Triage Cancer’s Quick Guide to Options When Losing Employer-Sponsored Health Insurance. We have additional information and resources to help you understand your options and pick a plan, on our Health Insurance Topics page

About Triage Cancer

Triage Cancer is a national, nonprofit providing free education to people diagnosed with cancer, caregivers, and health care professionals on cancer-related legal and practical issues. Through eventsmaterials, and resources, Triage Cancer is dedicated to helping people move beyond diagnosis.

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