Fired or Laid Off? Your Employer Now Has to Pay Your Insurance Costs Through September

 The American Rescue Plan has a lot to unpack. One of the provisions that has gotten the least amount of press attention is the fact that employers now have to pay your COBRA costs if you've been let go. This benefit starts April 1, 2021 and ends September 30, 2021. That's a heck of a lot of savings for unemployed workers.

Who is entitled: Anyone who loses their health insurance because they lost their job or had hours reduced, except those who voluntarily ended their employment. What is "voluntary" will probably be the subject of litigation. If you were forced to resign due to, for instance, discrimination, sexual harassment, or whistleblower retaliation, or your employer tells you that you have to resign, then that's constructive termination and you may still be eligible.

You didn't elect or coverage lapsed: If you already failed to elect COBRA or let it lapse because you couldn't afford it, don't despair. You can now elect COBRA. If you were entitled to elect COBRA continuation coverage before April 1, your insurance plan administrator has to send you notice within 60 days from April 1 of your entitlement to elect coverage now. If you are interested in a late election, I suggest contacting your plan administrator ASAP.

How much do you pay?: Zero from April 1 to September 30. After that, you have to pay your share of the premiums. Your employer will get a tax credit for paying it.

So, if you needed another reason not to quit, this is a biggie. If your employer tries to get you to sign something saying you quit voluntarily, better get some legal advice.

If You Have A Preexisting Condition, Choose COBRA or ObamaCare Over Your Mortgage

It used to be that when people lost their jobs, there was only one way to keep insurance coverage, and that was COBRA. The only problem is that when you lose your job, you have to pick and choose what bills to pay and COBRA is crazy expensive. Most people had to go bare. If they had preexisting conditions, it was literally a matter of life and death because they would never get insurance again.

Then came the Affordable Care Act, which is the same as ObamaCare if you haven't already figured that out. The ACA allowed people who lost their jobs to get alternative insurance that was much cheaper than COBRA. Plus, it both banned insurance companies from denying coverage due to preexisting conditions and also from charging more to those with preexisting conditions. So, yes, insurance rates went up for those who were healthy, but it saved billions in government-subsidized healthcare. The reason being that anyone who was uninsured had to go to publicly funded hospitals for all their healthcare needs.

Since the election, I've been warning people who lose their jobs to make sure they elect either ACA or COBRA, and under no circumstances to lose coverage if they have a preexisting condition because I thought preexisting condition coverage would be lost when Trump and the Republicans started to gut the ACA.

I've been accused of being an alarmist, but that's exactly what the latest proposal would do. While it would still prohibit insurers from denying health insurance to those with preexisting conditions, it allows them to raise premiums. A recent study made these findings:

Based on our analysis, we estimate that individuals with even relatively mild pre-existing conditions would pay thousands of dollars above standard rates to obtain coverage. For example, because an individual with asthma costs an issuer 106 percent more than a healthy 40-year-old, she would face a premium surcharge of $4,340. The surcharge for diabetes would be $5,600 per year. Coverage could become prohibitively expensive for those in dire need of care: Insurers would charge about $17,320 more in premiums for pregnancy, $26,580 more for rheumatoid arthritis and other autoimmune disorders, and $142,650 more for patients with metastatic cancer.

Because there are few things that can bankrupt you as quickly as medical bills, if you lose your job and have to choose between paying your mortgage and paying for insurance, the wise decision might just be to pay for insurance. While your mortgage company may work with you to allow you time to catch up, losing your coverage if the Republicans manage to repeal preexisting condition coverage may literally kill you.

If you care about this, call your Congress member and Senator now and tell them to stop this folly before they kill a bunch of people.

Preparing Yourself For The End of ObamaCare (Bracing for the Trumpocalypse Part I)

Well, Donald Trump is our President-elect. He has made a cascade of promises throughout the campaign, and many of them will affect the workplace. First up will be the repeal of the Affordable Care Act. That seems to be Republican priority number one. With control of the House, the Senate, the Presidency and soon the Supreme Court, they will get to do whatever they want for at least two years. So this is happening.

I'm going to write about all the laws/executive orders that will be affected by this so you can start to protect your family and yourself from economic disaster.

If you have a preexisting condition, it was ObamaCare that made it illegal to deny insurance coverage to you. That means when ObamaCare is appealed, you may never get insurance coverage again. If you are one of the 16.64 million Americans who are insured due to ObamaCare, you may lose that coverage. There has been some backpedaling such that maybe the preexisting condition provisions will stay when other provisions are repealed. We have no idea what, if anything, will replace the Affordable Care Act or if any of it will remain, and we have no idea how soon this may happen. I suggest preparing for repeal with zero replacement.

Here are some things you can do to help prepare yourself for the repeal of the Affordable Care Act, which could happen as early as January or February 2017:

1. Ask your insurance company what they plan to do. If ObamaCare is appealed, you may be dropped by your insurance plan. The first thing to do is ask what they plan to do. They may not even know what they plan to do yet if ACA is repealed, so stay vigilant. Read all those inserts they send you. Set a Google alert for your insurance company name and "Affordable Care Act."
2. Start looking for alternative plans. Find an insurance agent you trust who can point you to alternative plans if you lose coverage. Know which plan you will pick before you lose your insurance so you can switch quickly.
3. Encourage your employer to have an insurance plan. I know this seems like a long shot, but many employers have health insurance to keep good employees, to improve morale and also to improve attendance. Healthy employees show up more. 
4. Unionize. If your company won't provide insurance voluntarily, you have the right to discuss working conditions with coworkers and try to organize them. That includes the right to unionize. It may be time to unionize your workplace to protect yourselves against the upcoming war on workers.
5. Look for a job with insurance. Now might be a good time to find alternative employment that does have insurance if your job doesn't cover you.
6. Put money in your health care savings. Many employers offer a health savings account. If you have a preexisting condition and may not be able to keep insurance, this may be your best option for now. It won't stop the catastrophic loss that will occur if you are hospitalized, but it will help with regular doctor bills.
7. Switch to your spouse's insurance. If your spouse's employer has insurance coverage, now is the time to switch from your Affordable Care Act insurance.

The Trump win has already affected the way I advise clients. I used to advise people who lose their jobs to look at their Affordable Care Act options along with COBRA, because ACA is almost always cheaper than COBRA, which is crazy expensive. It was nice while it lasted, but now I'm telling people not to sign up for ACA and to elect COBRA if they can because ACA won't be around much longer.

This is literally a matter of life and death for many people. Next time, vote better.

My Readers Change The World! ObamaCare COBRA Gap Fixed

I wrote a few weeks ago about The Little-Known ObamaCare COBRA Catch-22. I thought this issue was so important that I asked AOL Jobs readers for help. I asked you to sign a petition I started to alert the President to this issue. I asked you to tell the President to close the gap. And you came through.

Not only did you sign the petition, but some of you took action to help. Members of the National Employment Lawyers association contacted the Department of Labor to ask for a fix. Forbes found out about this issue and wrote a piece about it. And it worked.

Read my article at AOL Jobs to find out how you can switch from COBRA to ACA until July 1 and how COBRA notices are changing. Thanks so much to everyone who helped with this important change.

The Little-Known Obamacare COBRA Catch-22

When I'm negotiating severance packages for employees, many times employers will offer to pay a month or more of COBRA payments. COBRA is the law that says employers have to let employees who lose their jobs stay on the company's insurance for up to 18 months as long as the employee pays 100% of the premium. Those premiums can be huge: $1,000 or more sometimes. Getting the employer to pick up some of the premiums can be a huge benefit.

Until now, that is.

Find out about the problem I found that occurs if you lose your job after open enrollment by reading my article at AOL Jobs.You have an important choice to make on health insurance. Find out before you enroll in COBRA and before you sign any severance agreement. You're stuck with the choice you make until the next open enrollment in November.

Then, if you think this is a serious problem, tell President Obama by signing the petition I created, which only needs 24 more signatures to go up on the public website (where it will have to gather 100,000 signatures by May 4, so time's a-wasting). Do it today.

What You Need To Know About Your Employer's Health Insurance

No Federal law requires your employer to carry health insurance coverage for employees (a few states, like Massachusetts and Hawaii, are different). However, once they do have coverage, there are some Federal requirements employers must comply with. If your employment has ended, read the paperwork you get on COBRA to find out about your rights to continued coverage. If you're still employed or about to be employed, here's what you need to know about your insurance.

Non-discrimination: Your employer must not discriminate in providing or reducing coverage based on , for example, age, disability or pregnancy.

Plan description: The Employee Retirement Income Security Act (ERISA) requires your employer to provide a description of your plan and how to make claims.

Privacy of records: If your employer does have access to medical records, such as when it’s self-insured, it must comply with the privacy requirements of HIPAA.

Specific coverage requirements: Certain procedures must be covered once insurance is provided. For instance, if mastectomies are covered, then reconstructive surgery must also be covered. Insurance can’t restrict the length of hospital stays for the birth of a child to less than 48 hours for vaginal delivery or 96 hours for c-section.

Preexisting conditions: HIPAA limits exclusions for preexisting conditions to no more than 12 months, and allows plans to look back no more than 6 months. Pregnancy and genetic information can never be excluded. If you were covered by a prior plan and had less than a 63 day break in coverage, preexisting conditions won’t be excluded. Most children can’t be excluded based on preexisting conditions.

Health factors: You can’t be denied insurance or have benefits reduced due to your health status, physical or mental illness, claims experience, receipt of health care, medical history, genetic information, conditions arising from domestic violence, participation in hazardous activities, or disability.

Certificate of coverage: The employer must provide a certificate of coverage automatically at certain times, and upon request.

Young adults: Your plan must allow you to have your children covered up to age 26.

Lifetime limits: No lifetime limits on coverage are allowed anymore. Most plans won’t be able to have annual limits.

Rescission: If you become ill, the insurance company can’t look for unintentional mistakes on your application as an excuse to deny coverage.

Eliminate or reduce coverage: Your employer can eliminate coverage or change plans at will.

Donna’s tips:

a. Your employer has to disclose if it believes its plan is “grandfathered” and exempt from some of the new health care reform’s requirements. If it is grandfathered and significant changes are made to the plan, it might lose its grandfathered status and have new requirements.

b. Non-grandfathered plans must provide access to pediatricians and OB-GYNs and coverage of preventive services with no cost sharing.

c. Read your plan and understand it. Don’t wait until a crisis to understand your health care coverage and rights.