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Covered California Q&A

Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.


COBRA and Subsidy Eligibility?

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Question: I applied for coverage and have a COBRA plan that is way above the 9.5% of income, but when I answer on the application that I have COBRA it remove the subsidy? on the application how do I explain that the Cobra premium is above 9.5% and that a subsidy should be applied?

Answer: You are free to drop the COBRA plan and enroll in a Covered California qualified plan with eligibility for APTC anytime during the open enrollment period. Select, “None of the above” in answer to the question about other coverage, as if you had already cancelled you COBRA coverage. Dropping COBRA outside of open enrollment will not create a special enrollment period so you can’t be eligible until the next open enrollment period, COBRA was meant to protect individuals who lost their group coverage in a medical underwriting environment where they may not have qualified for individual coverage. The ACA did not intend for COBRA to be an obstacle for individuals desiring coverage and premium assistance through the exchange. Being held hostage by a costly COBRA plan because of preexisting conditions is one of the problems the ACA seeks to solve.

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I have had Cobra since I lost my job. However, I am still unemployed and my Unemployment has now stopped. Therefore, I can no longer afford the Cobra premium. Since I am also outside the open enrollment period for Covered Calif, what do I do? How can I obtain coverage in this circumstance?

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