Kodi inshuwaransi yazaumoyo ya COBRA ndi chiyani?

Kampani Healthcare Yafotokozedwa

COBRA ikhoza kutulutsa zithunzi za njoka yoopsa, koma kwenikweni ndi lamulo lothandiza anthu omwe achotsedwa ntchito kapena kuwona maola awo atachepetsedwa kuti asunge inshuwaransi yazaumoyo. Amatchedwa COBRA chifukwa amatchulidwa kuti Consolidated Omnibus Budget Reconciliation Act ya 1985.

Kuyambira mu 2018 , Achimereka 49% adalandira inshuwaransi yawo monga gawo lamagulu azaumoyo kudzera kwa owalemba ntchito. Ngati anthuwa ataya ntchito kapena akuwona kuti nthawi yawo yogwira ntchito yochepetsedwa kuchokera kuntchito yonse kupita ku maganyu osapindula ndi zaumoyo-monga zachitika pamlingo waukulu wa mliri wa COVID-zitha kukhala zovuta. Ndipamene COBRA imalowererapo. Imalola anthu kukhalabe pagulu kwakanthawi kwakanthawi pomwe akupeza njira ina yothandizira inshuwaransi yazaumoyo.

Ngakhale izi zikumveka ngati njira yabwino, inshuwaransi ya COBRA nthawi zambiri imakhala yokwera mtengo kuposa mapulani a omwe akugwira ntchito mwakhama ndipo nthawi zambiri sikhala yotsika mtengo kwambiri. Komabe, ilipo kuti iteteze ogwira ntchito omwe alibe zisankho munthawi yochepa.

ZOKHUDZA: Kodi inshuwaransi yanthawi yayitali ndi yotani?

Kodi inshuwaransi ya COBRA ndi chiyani?

COBRA ndi lamulo loyendetsedwa ndi boma komanso US department of Labor, koma mayiko ambiri ali ndi malamulo awo omwewo. Kwenikweni, kukhala ndi inshuwaransi ya COBRA-yomwe imadziwikanso kuti COBRA kupitiriza kufotokozera - zikutanthauza kuti inu ndi banja lanu mumaloledwa kukhala pagulu lothandizirana ndi abwana anu kwakanthawi kochepa pambuyo poti ntchito yanu ithe kapena mutasintha.

Koma sikuti aliyense amene wataya ntchito akuyenera kulandira chithandizo cha COBRA. Lamuloli limangogwira ntchito m'mabizinesi omwe ali ndi antchito 20 kapena kupitilira apo. Ena akuti 'malamulo ngati a COBRA amakhudza mabizinesi ang'onoang'ono. Malamulowa nthawi zambiri amatchedwa mini-COBRAs.

Kuti muyenerere COBRA, muyeneranso kuti mwakumana ndi chochitika choyenerera, chomwe chimaphatikizapo kuchotsedwa ntchito ngati china chilichonse kupatula machitidwe olakwika kapena kuchepetsa maola. Malinga ndi department of Labor , okwatirana kapena ana omwe amadalira ogwira nawo ntchito akuyenera kulandira COBRA pazochitika zotsatirazi:

• kusudzulana kapena kulekana mwalamulo ndi wogwira ntchitoyo
• Imfa ya wantchito
• mwana womudalira amakhala ndi zaka 26 ndipo salinso woyenera kulandira dongosolo laumoyo wa wogwira ntchitoyo malinga ndi Affordable Care Act (ACA)

Kuti ayenerere, wogwira ntchito (kapena mkazi wake kapena ana ake omwe amadalira) ayenera kuti adalembetsa mgulu la kampani ya inshuwaransi tsiku lisanachitike chochitikacho, ndipo dongosololi liyenera kupitilirabe kwa ogwira ntchito pambuyo chochitika choyenerera.

Kodi ndingalembetse bwanji COBRA?

Pambuyo paphwando loyenera, olemba anzawo ntchito amafunika kuti alandire omwe adzapindule nawo kuti adziwe ngati ali ndi mwayi wokhala ndi COBRA, ndipo mwina wolemba anzawo ntchito akuyenera kulola kampani ya inshuwaransi yomwe ikutsogolera gulu kuti idziwe za mwambowu.

Ndiudindo wa wolemba ntchito kudziwitsa mapulaniwo pasanathe masiku 30 kuti awa zochitika zoyenerera :

• inaphimba kuchotsedwa kwa wogwira ntchito
• kuchepetsa maola ogwira ntchito ogwira ntchito
• inaphimba imfa ya wantchito
• Wogwira ntchito amakhala woyenera ku Medicare
• kampani yabizinesi yakampani yabizinesi isokonekera

Wogwira ntchito kapena aliyense wopindula woyenera ali ndi udindo wodziwitsa dongosololi ngati chochitikacho ndi chisudzulo kapena kulekana mwalamulo, kapena ngati mwana ataya mwayi wake wodalira gulu.

Dongosololi likadziwitsidwa, kampani ya inshuwaransi ikuyenera kupatsa mwayi kwa omwe adzapindule nawo chidziwitso chofotokoza za ufulu wawo pansi pa COBRA ndi momwe angasayinire kuti apitirize kufalitsa. Chidziwitso cha chisankhochi chiyenera kuperekedwa kwa omwe adzapindule nawo pasanathe masiku 14. Mukalandira chidziwitso cha chisankho, mudzakhala ndi masiku 60 oti musankhe kusankha COBRA kapena ayi.

Wophunzira aliyense woyenereradi omwe angathenso kupanga pulani ya gululi atha kupanga chisankho chake pankhani ya inshuwaransi ya COBRA, ndipo ngati wopindulapo aliyense ataya mwayi wokhudzana ndi COBRA, amaloledwa kubweza kuchotsedwako ndikusankha kufalikira kwa COBRA pambuyo pake, bola atatero 60 yomweyo -masiku amasankho.

Kodi COBRA imatenga nthawi yayitali bwanji?

Kutalika kwa nthawi yomwe COBRA imakhalapo kumatengera chochitika choyenera komanso dongosolo la kampaniyo. Consolidated Omnibus Budget Reconciliation Act imafuna kuti kupitirizabe kufalitsa kulipo kwa miyezi 18 kapena 36, ​​koma mapulani ena azaumoyo atha kupitilira pamenepo.

Ngati mutaya ntchito kapena mukuwona kuchepa kwa maola pantchito, muli ndi mwayi wopeza chindapusa cha COBRA kwa miyezi 18. Zochitika zina zoyenerera (kupatula kuyenerera kwa Medicare) zimapangitsa kuti mukhale ndi mwayi wopeza miyezi 36.

Komabe, ngati kufalitsa kwanu kuli kotsekedwa m'miyezi 18, mutha kukhala oyenera kukulitsidwa muzochitika ziwiri: Choyamba, ngati ndinu olumala ndikukwaniritsa zofunikira, momwe kufotokozera kwa onse omwe adzapindule nawo kumatha kupitilira miyezi 11 . Chachiwiri, ngati chochitika chanu choyenerera chimakuchititsani kuti musayenerere kubisalanso. Zochitika izi zimaphatikizapo kumwalira kwa wogwira ntchito, kusudzulana kwa wogwiridwayo, wogwiridwayo kukhala woyenera ku Medicare, kapena mwana yemwe wataya mwayi wodalira gulu. Pazochitikazi, kufalikira kwa COBRA kumatha kupitilizidwa miyezi 18 mpaka miyezi 36 yonse.

Medicare ndi COBRA

Wogwira ntchito atakhala woyenera ku Medicare pasanathe miyezi 18 chochitikacho chisanachitike, kupitiriza kufalitsa nkhani kwa mkazi ndi ana omwe akumudalira kumatha miyezi 36, kuchotsera miyezi yomwe wogwira ntchitoyo anali woyenera ku Medicare. Mwachitsanzo, ngati wogwira ntchitoyo akuyenera kukhala ku Medicare kwa miyezi 10 isanachitike, ena omwe adzapindule nawo pantchitoyo azikhala ndi mwayi wopeza COBRA kwa miyezi 26.

Ndizotheka, ndipo nthawi zina amalimbikitsidwa, kukhala ndi COBRA ndi Medicare kufalitsa nthawi imodzi. Kuti mumve zambiri zamomwe kuyenerera kwa Medicare kumakhudzira kufalikira kwa COBRA, a department of Labor's Benefits Security Administration atha kufikiridwa askebsa.dol.gov kapena patelefoni pa 1-866-444-3272.

Zimawononga ndalama zingati COBRA?

Pafupifupi nthawi zonse, kufalitsa kwa COBRA kumakhala kotsika mtengo kuposa momwe zimakhalira ndi ogwira ntchito omwe akuchita.

Pansi pa Affordable Care Act, mapulani azaumoyo ogwira ntchito amafunikira kuti azitha kufotokozera zochepa kapena bwino. Kutsika kochepa ndi kumatanthauzidwa ngati pulani yomwe imalipira osachepera 60% ya mtengo wathunthu wazithandizo zamankhwala kwa anthu wamba, ndipo imaphatikizapo kufotokozera kwakukulu kwa zamankhwala komanso zipatala za odwala. Masambawo anaphimba ogwira ntchito kuti alipire 40%.

Nthawi zambiri, pansi pa COBRA, simukhalanso ndi abwana anu kulipira gawo la 60%, zomwe zikutanthauza kuti mutha kukhala pachiwongola dzanja pamtengo wonse wa inshuwaransi. M'malo mwake, malinga ndi lamulo la COBRA kampani ya inshuwaransi imaloledwa kulipiritsa mpaka 102% ya mtengo wamapulani ofanana ndi omwe amagwira ntchito (owonjezera 2% amapita kuzoyang'anira). Ndipo ngati mutenga zowonjezera za miyezi 11 zakulemala, kampani ya inshuwaransi imaloledwa kulipiritsa mpaka 150% ya mtengo wokhazikika wamapulaniwo kwa miyezi 11 ija.

Zonse zanenedwa, zikutanthauza kuti malipiro a inshuwaransi yazaumoyo - ndalama zomwe amalipira ku kampani ya inshuwaransi pafupipafupi-zitha kukhala zodula kwambiri pansi pa COBRA. Ndipo ngakhale ndi COBRA, opindulitsabe amafunika kulipira ndalama zolipirira madokotala pafupipafupi komanso kuchotsera chaka chilichonse (kuchuluka kwa omwe ali ndi inshuwaransi ayenera kulipira inshuwaransi isanayambike). Ndalama zomwe mumalipira zitha kukwera ngakhale mtengo wamagulu ukukwera.

Lamulo la COBRA limanena kuti kampani ya inshuwaransi ikuyenera kukulolani kuti mulipire ndalama pamwezi ngati mungasankhe. Zina mwazinthu zingakupatseninso mwayi wolipira sabata iliyonse kapena kotala kamodzi. Opindula oyenerera nthawi zambiri amayenera kulipiritsa koyamba mu masiku 45 kuyambira pa inshuwaransi ya COBRA. Ngati mwaphonya kulipira, kampani ya inshuwaransi iyenera kukupatsani nthawi yamasiku 30 yoperekera ndalama, koma pambuyo pake, ngati kulipira sikunaperekedwe, mutha kutaya phindu lanu lonse la COBRA.

Njira zina za COBRA

Popeza mtengo wa inshuwaransi ya COBRA, department of Labor ikulimbikitsa kuti anthu omwe akumana ndi zochitika zaposachedwa ayang'ane inshuwaransi yotsika mtengo m'njira zosiyanasiyana. Nazi njira zingapo zofotokozera:

Ndondomeko yaumoyo wa mkazi kapena mwamuna: Ngati banja lanu litaya ntchito yothandizidwa ndi abwana anu, fufuzani kuti muwone ngati wolemba anzawo ntchito akupereka inshuwaransi yazaumoyo. Izi zitha kukhala zotsika mtengo kuposa kupitiriza kufalitsa kwanu ndi COBRA.

Dongosolo lina la gulu: Ngati mutaya inshuwaransi yantchito yanu, inu, mnzanu, kapena omwe mumadalira mutha kuloledwa kulembetsa nawo dongosolo lina laumoyo munthawi yolembetsa. Izi zikutanthauza kuti simuyenera kudikirira mpaka nthawi yotsatira yolembetsa.

Msika wa Inshuwaransi Yathanzi: Chochitika choyenerera chimakupatsaninso mwayi wogwiritsa ntchito nthawi yapadera yolembetsa kuti mulembetse kudzera Msika wa Inshuwaransi ya Umoyo kapena kusinthana kwa inshuwaransi yaboma lanu. Apa ndipomwe mungafanizire ndondomeko ndikuwona ndalama zoyendetsedwa, zochotseredwa, ndi zolipirira mthumba. Simufunikiranso kudikira lotsatira nthawi yolembetsa , ndipo ngati mungapeze inshuwaransi yazaumoyo kudzera Msika, mutha kukhala woyenera kulandira ngongole yamsonkho yomwe ingachepetse ndalama zanu. Kuti mulembetse dongosolo la Msika, pitani ku healthcare.gov kapena itanani 1-800-318-2596.

Medicaid kapena Program ya Inshuwaransi ya Ana (CHIP): Kwa mabanja omwe amalandira ndalama zochepa komanso anthu omwe ali oyenerera, Medicaid ndi CHIP amapereka chithandizo chotsika mtengo kapena chosagula. Kuti muwone ngati mukuyenera kulandira Medicaid, pitani patsamba lanu la Medicaid kapena ku US department of Health and Human Services ku hhs.gov . Kuti mulembetse ku CHIP, imbani 1-800-318-2596 kapena lembani fomu kudzera pa Msika wa Inshuwaransi Yathanzi .

Momwe mungasungire pamankhwala omwe muli kapena opanda COBRA

Ngakhale mutasankha kuti COBRA ipitilize kufalitsa kapena ayi, mutha kupulumutsa pamankhwala azachipatala omwe ali ndi makuponi ochokera ku SingleCare. Ndi zaulere kugwiritsa ntchito ndipo mupeza mitengo yomwe ingakhale yotsika mtengo kuposa inshuwaransi yanu. Yambani kusaka singlecare.com za mankhwala anu ndikuwona zomwe mungapulumutse.