What happens if I lose health insurance coverage through my employer due to layoff?

  • If you experience a loss of health insurance coverage due to a layoff, it is important to contact a local benefits expert and review your options. Your options may vary depending upon your situation. Sanford Health Plan is here to help. We can connect you with a local licensed agent to review your options – which may include COBRA through your employer, Individual coverage, or possibly Medicaid or Medicaid Expansion depending on the state you live in.
  • Don’t wait—start investigating right away. You might have access to employer-based coverage through a family member’s plan. If you are younger than 26, the Affordable Care Act allows you to be covered under your parent’s insurance plan. In addition, if your spouse has employer-based health insurance, see if you can be enrolled in their plan.
  • Consider individual and family coverage through the Marketplace – or directly through Sanford Health Plan. The loss of employer coverage most likely qualifies you for a Special Enrollment Period outside of the typical Open Enrolment timeframe with any insurance carrier you choose. Sanford Health Plan can help you navigate your options and connect you with a licensed agent.
  • Depending on the state you live in, you may want to check your Medicaid or Medicaid Expansion eligibility — even if you don’t think you qualify. This may not be your first instinct if you’re used to having job-based coverage, but it’s worth looking into. Medicaid offers free or low-cost care and comprehensive benefits. Coverage can take retroactive effect as far back as three months, as long as you were eligible during that retroactive period.
  • COBRA, short for the Consolidated Omnibus Budget Reconciliation Act, generally lets workers at companies of 20 or more employees extend their health coverage for up to 18 months after losing their jobs. It is important to note that you would now be responsible for paying both your portion and your employer’s portion of the premium — plus a 2% administrative fee. Electing to use COBRA allows you to keep your accumulators for deductible/OPM cost-share. It is an important to consider this option.
  • While the low cost of these plans can be appealing— understanding this type of plan and exactly what it will cover or not cover is important. Short-term plans often will not offer coverage to people based on preexisting conditions and offer relatively limited benefits. They are often meant to provide catastrophic coverage during a short time-frame. We would recommend working with a licensed agent to review and understand how any short-term plan you are considering would work.
  • Individuals over age 65 will likely transition to a Medicare plan. If they’ve not been enrolled in Medicare Part A and Part B, there’s an employer form that documents they’ve been on the group health plan after age 65: the form CMS-L564. It’s important employers ensure individuals over 65 receive this form quickly because that will facilitate their enrollment into Medicare as quickly as possible.

 

Sanford Health Plan is here to help.

Contact us today to learn more about your options or to be connected with a licensed insurance agent.