If you’re like most Americans, you count on your employer for health insurance coverage. But what would happen to your health insurance if you suddenly stopped working or no longer qualified for benefits? 没有人能预测未来. It’s possible that your company could lay you off or reduce your hours to part-time, 你的配偶可能会死, 否则你们的婚姻可能以离婚告终. If something unexpected happened, you could be left without health benefits. 记住, buying private health insurance on your own can be pretty costly, 尤其是当你失业的时候.
Fortunately, there’s the Consolidated Omnibus Budget Reconciliation Act of 1986 (眼镜蛇). 眼镜蛇 can prove to be a real lifesaver for you and your family when your health coverage is jeopardized. You may also benefit from the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 是谁进一步推进了医疗改革.
The Consolidated Omnibus Budget Reconciliation Act of 1986 (眼镜蛇) may help you continue your health insurance coverage for a time
眼镜蛇 is a federal law designed to protect employees and their dependents from losing health insurance coverage as a result of job loss or divorce. If you and your dependents are covered by an employer-sponsored health insurance plan, a provision of 眼镜蛇 entitles you to continue coverage when you’d normally lose it. Most larger employers (20+ employees) are required to offer 眼镜蛇 coverage.
作为一个员工, you’re entitled to 眼镜蛇 coverage only if your employment has been terminated for any reason other than gross misconduct or if your hours have been reduced. 然而, your spouse and dependent children may be eligible for 眼镜蛇 benefits if they’re no longer entitled to employer-sponsored benefits because of divorce, 死亡, 或者其他事件.
Unfortunately, you can’t continue your health insurance coverage forever. You can continue your health insurance for 18 months under 眼镜蛇 if your employment has been terminated or if your work hours have been reduced. If you’re entitled to 眼镜蛇 coverage for other qualifying reasons, 你可以续保36个月.
- Divorce: If your former spouse maintained family health coverage through work (and works for a company with at least 20 employees), you may continue this group coverage for up to 36 months after the divorce or legal separation. 不过，你得付这笔保险费用. Your cost of continuing coverage cannot exceed 102 percent of the employer’s cost for the insurance. 眼镜蛇 coverage will terminate sooner than 36 months if you remarry or obtain coverage under another group health plan.
- Company goes out of business: Unfortunately, you may be out of luck here. If your company goes out of business and no longer has a group health insurance policy in force, 那么眼镜蛇的保险将无法提供. (A possible exception involves union employees covered by a collective bargaining agreement.)
记住, 无论你的情况下, your employer may require individuals who elect continuation coverage to pay the full cost of the coverage, 再加上2%的管理费. 然而, if you’re eligible for 眼镜蛇 coverage and don’t have any other health insurance, 你应该接受它. Even though you’ll pay a lot more for coverage than you did as an employee, it’s probably less than you’ll pay for individual coverage. 你不用接受任何健康检查, 测试, or other pre-existing medical condition requirements when converting to a 眼镜蛇 contract. Your 眼镜蛇 benefits and coverage will be identical to those provided to similarly enrolled individuals.
The Health Insurance Portability and Accountability Act of 1996 expanded 眼镜蛇
In 1996, HIPAA expanded certain 眼镜蛇 provisions and created other health-care rights. In many ways, HIPAA took a significant step toward health-care reform in the United States. 其中一些条款可能会影响到你. HIPAA的主要规定:
- Allow workers to move from one employer to another without fear of losing group health insurance
- Require health insurance companies that serve small groups (2 to 50 employees) to accept every small employer that applies for coverage
- Increase the tax deductibility of medical insurance premiums for the self-employed
- Require health insurance plans to provide inpatient coverage for a mother and newborn infant for at least 48 hours after a normal birth or 96 hours after a cesarean section
For example, assume you’re pregnant and covered by a group health insurance plan at work. 你决定去另一家公司工作. HIPAA下, pregnancy cannot be considered a pre-existing condition for a woman who’s changing jobs if she was previously covered by a group health insurance plan. 如果你以前的工作有保险, you can’t be denied health insurance coverage at your new job simply because you’re pregnant.
然而, many companies require you to be employed for 30 days or more before you become eligible for coverage. 如果你接近怀孕的尾声, 这个要求给你带来了一个问题, you may be eligible for coverage under 眼镜蛇 through your former employer.
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