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SAG-AFTRA Health Plan Federal COBRA Subsidy ($0 COBRA Premium) FAQs

*Page updated: May 18, 2021

Qualified individuals should return their paperwork by May 15 to ensure continuous coverage.

I received a packet of information and forms in the mail. I think I am eligible for the federal COBRA subsidy. How do I enroll?

  1. Enroll in COBRA if you are not already enrolled. Log in to your Benefits Manager and follow the prompts to enroll (fastest) or mail it in the self-addressed envelope AND
  2. Complete the paper COBRA Premium Assistance Application Form and  mail it in the self-addressed envelope included in the packet you received.

While you have 60 days to enroll and apply for COBRA Premium Assistance, to ensure continuous coverage, please return these forms as soon as possible. 

Federal guidance requires the Plan send these packets with COBRA and subsidy information to all participants who lost coverage between November 1, 2019 and April 1, 2021 even if they would not qualify for the federal subsidy due to being eligible for Medicare or other group coverage.
 

General

Eligibility

Enrollment and Premiums

Covered Benefits

COBRA Payments

When COBRA Subsidy Ends


General

What is COBRA insurance?

COBRA stands for Consolidated Omnibus Budget Reconciliation Act of 1985. It's a federal law that gives individuals who lose their health coverage due to a Qualifying Event, such as job loss (other than voluntary) or hours reduction, the option to continue their coverage for a limited amount of time. For the SAG-AFTRA Health Plan, this includes people who lost coverage because they did not meet the earnings requirement.

For more COBRA information, see the program summary.

How long will the American Rescue Plan’s $0 COBRA subsidy be in effect?

The new COBRA subsidy ($0 COBRA subsidy) is available for periods of coverage starting April 1, 2021 and ending September 30, 2021. However, it will end earlier if your maximum period of coverage (generally, 18 months) ends earlier than September 30, 2021. It will also end earlier if you become eligible for coverage under another group health plan or Medicare. 

Note: If you become eligible for another group health plan or Medicare, you must notify the Plan. 


Eligibility

Who is eligible for the $0 COBRA premium?

Participants who do not meet or have not met the Health Plan’s covered earnings or days requirements are eligible for this subsidy. The $0 subsidy is for COBRA coverage beginning on or after April 1, 2021. In addition, family members who are no longer covered by the Health Plan because the participant did not meet the Health Plan’s covered earnings or days requirements may also be eligible for this subsidy. Personalized information has been mailed and emailed to eligible individuals. Individuals who lose Active coverage beginning July 1, 2021 will receive a COBRA offer and subsidy application with their Active coverage termination letter in late May.
The temporary $0 COBRA premium is available to any participant (or family member) who, because the participant did not meet the Health Plan’s covered earnings or days requirements:  

  • Is enrolled in COBRA, or becomes eligible for COBRA, on or after April 1, 2021, and before the subsidy ends on September 30, 2021; or
  • Became eligible for COBRA on or after November 1, 2019, such that the period of COBRA coverage to which they would be entitled (18 months) includes any month between April and September of 2021—even if the individual did not elect COBRA when it was initially offered or elected COBRA but dropped it before April 1, 2021. In most cases, this means the participant was no longer eligible for the Health Plan as early as January 1, 2020.

Who is not eligible for the $0 COBRA premium?

The $0 COBRA premium is not available when:

  • COBRA is triggered by other qualifying events (e.g., death, divorce or dependent child aging out).
  • You are eligible for coverage under any other group health plan (including coverage as a dependent under your spouse or parent’s other group health plan).
  • You are eligible for Medicare.
  • Your loss of coverage was not based on a reduction in hours or involuntary termination.

Are my family members eligible for the $0 COBRA premium?

Yes, if the participant loses coverage due to a reduction in hours or involuntary termination (including not meeting the earnings or days requirements), also called a Qualifying Event, any family member covered prior to that Qualifying Event who also lost coverage when the participant did may be eligible for the federal COBRA subsidy. In order to receive the federal subsidy, the individual cannot be eligible for Medicare or other group coverage.

Will the $0 COBRA premium be available to me if I am going on COBRA starting April 1, 2021?

Yes, the $0 COBRA premium will be available to assist eligible individuals for coverage beginning April 1.

I already received a COBRA offer for April 1, 2021. Will I receive a new offer that shows the subsidy?

Yes. You will receive a COBRA Premium Assistance Application Form to complete and return.

I elected COBRA due to a reduction in hours or involuntary termination before April 1, 2021 but discontinued it. Am I eligible to resume COBRA now and receive the subsidy?

Yes, if you are not eligible for other group health coverage or Medicare.

I was offered COBRA due to a reduction in hours or involuntary termination before April 1, 2021, but I did not take it at that time. Am I eligible for the subsidy now?

Yes, if you are not eligible for other group health coverage or Medicare.

I elected COBRA due to reduction in hours or involuntary termination before April 1, 2021, but discontinued it. Am I eligible to resume COBRA now and receive the subsidy?

Yes, if you are not eligible for other group health coverage or Medicare.

Are Medicare-Eligible participants including Senior Performers who lost or are losing Active coverage before April 1, 2021, eligible for the $0 COBRA premium?

No. Individuals who are eligible for Medicare cannot get the subsidy. However, if you are Medicare-eligible and enrolled in the Temporary COBRA Relief or Extended Career COBRA program, reduced premiums will continue. You will also receive Notices and forms from the Plan because the federal guidance requires that the Plan inform you of your COBRA rights and the federal subsidy even though you would not be eligible.

I am a Medicare-Eligible non-Senior Performer. I do not have sufficient health credits to qualify for medical coverage. Am I eligible for the $0 COBRA premium?

No. Individuals who are eligible for Medicare do not qualify for the premium.

I expect to receive a COBRA offer due to a reduction in hours or involuntary termination on July 1, 2021. Am I eligible for the $0 COBRA premium?

Yes. If you are not eligible for other group health coverage or Medicare, you are eligible to receive the premium until September 30, 2021. After that, you will have to pay regular COBRA rates in order to continue your coverage.

I lost coverage before April 1, 2021, received a COBRA offer and did not enroll in COBRA at the time of the offer. I subsequently became eligible for Active coverage, but again, did not enroll at that time. Am I eligible for the $0 COBRA premium now?

No.

I lost coverage the end of 2019 because I didn’t meet the earnings requirement due to a reduction in hours or involuntary termination. I was mailed a COBRA offer for January 1, 2020. I didn’t enroll at the time. Am I eligible for the $0 COBRA premium now?

Yes, however, you aren’t eligible for the full 6 months. You’re only eligible for the months that you continue to be eligible for COBRA. In other words, you are eligible for the $0 COBRA premium if you were no longer eligible for the Health Plan starting January 1, 2020. Since you are only eligible for a maximum of 18 months of COBRA continuation coverage (measured from your loss of coverage starting January 2020), you will only be eligible to receive the subsidy for the months of April, May and June 2021. June is your 18th month of COBRA continuation coverage. You will receive a notice from the Plan regarding the expiration of your COBRA period and the subsidy in May.

I lost coverage in March 2019 because I did not meet the earnings requirement. I was mailed a COBRA offer for April 1, 2019. I did not enroll at the time of the offer. Am I eligible for the $0 COBRA premium now?

No. A typical COBRA coverage period is 18 months. To be eligible for the $0 COBRA premium, you would’ve had to be eligible for COBRA due to a reduction in hours or involuntary termination on or after November 1, 2019.

If I am already on the Temporary COBRA Relief Program with the Plan, can I switch to the $0 COBRA premium? What do I need to do to switch?

Yes. If you are already on the Plan’s Temporary COBRA Relief Program or Extended Career COBRA and you are eligible for the $0 COBRA premium, the Temporary COBRA Relief Program or the Extended Career COBRA will be suspended during the time you are eligible for the 100% federal premium.

That means that you will pay $0 of COBRA premiums during the federal subsidy period. Once you are no longer eligible for the federal subsidy, you will again be eligible for the Plan’s subsidy programs, if you have any time left in your COBRA period. More information on how this process and switch will work will be available once the federal government provides additional guidance.

Medicare-eligible individuals are not eligible for the $0 COBRA subsidy but the Plan will continue to provide the Temporary COBRA Relief Subsidy to eligible individuals until the end of their subsidy period.

I am on COBRA now due to reduction in hours or involuntary termination, but my period ends before September 30, 2021. Will I be eligible for the $0 COBRA premium?

Yes. The premium period ends September 30, 2021. If you are still eligible for COBRA after April 1, 2021, you may be eligible to receive the $0 COBRA premium for the remaining months of your COBRA coverage.

I’m eligible for group health coverage through my spouse’s employer, but I am not enrolled. Does this mean I am not eligible for the $0 COBRA premium?

Yes, this does mean you are not eligible for the $0 COBRA premium since you are eligible for other group health coverage. Eligibility for excepted benefits (such as limited-scope dental or vision coverage), a health flexible spending arrangement or a qualified small employer health reimbursement arrangement would not terminate subsidy eligibility.

My spouse has group coverage but I am not currently covered under my spouse’s plan even though I am eligible for coverage under the plan as a dependent. Am I eligible for the $0 COBRA premium?

No, individuals eligible for coverage under another group health plan are not eligible for the $0 COBRA premium.

I am currently covered by an ACA plan. Can I disenroll from my ACA plan and elect the $0 COBRA premium?

Yes. You may be eligible for a special enrollment period in the ACA Marketplace when the premium ends.


Enrollment and Premiums

I am already enrolled in COBRA. How do I enroll for the $0 COBRA premium?

If you lost coverage due to a reduction in hours or involuntary termination, have at least a month of COBRA available as of April 1, 2021 and are already enrolled in COBRA, the Plan has not charged you for your April premium and will not deduct your May premium. Special enrollment materials were mailed to you by our partner Calibrated on April 21. You must complete and return the Premium Assistance Application form and not be eligible for other group health plan coverage in order to continue in the $0 COBRA premium program.

While you have 60 days to enroll and apply for COBRA Premium Assistance, to ensure continuous coverage, please return these forms as soon as possible. Mail your completed form  in the self-addressed envelope included in the packet you received. 

I am not currently enrolled in COBRA. How do I enroll for the $0 COBRA premium?

If you lost coverage due to a reduction in hours or involuntary termination, have at least a month of COBRA available as of April 1, 2021 and are not already enrolled in COBRA you can pre-enroll in the $0 premium COBRA on Benefits Manager beginning April 9. Special enrollment materials were mailed to you by our partner Calibrated on April 21. You must enroll in COBRA either through Benefits Manager or complete and return the paper form in the self-addressed stamped envelope along with the completed Premium Assistance Application form and not be eligible for other group health plan coverage in order to continue in the $0 COBRA premium program.

While you have 60 days to enroll and apply for COBRA Premium Assistance, to ensure continuous coverage, please return these forms as soon as possible. Mail your completed form  in the self-addressed envelope included in the packet you received. 

When I fill out the special enrollment forms for the $0 COBRA subsidy, will I be required to validate my eligibility or make any attestation?

You will receive an election form and Premium Assistance Application form to fill out. You must follow the instructions and return the required information. If you are not eligible for the $0 COBRA subsidy per the criteria defined in the American Rescue Plan Act, you will be charged a full COBRA premium or Temporary COBRA Relief or Extended Career COBRA premium, depending on what you qualify for.

While you have 60 days to enroll and apply for COBRA Premium Assistance, to ensure continuous coverage, please return these forms as soon as possible. Mail your completed form  in the self-addressed envelope included in the packet you received. 

I am not eligible for the federal COBRA subsidy because I am eligible for other insurance. I also currently pay the Temporary COBRA Subsidy from the Plan. Can I enroll just my federal subsidy-eligible family members in the federal COBRA subsidy program?

Yes. Please contact the Plan.

I am over 65 and eligible for Medicare, but do not qualify for the Senior Performers HRA Plan. I have two dependents who are eligible for the federal COBRA subsidy. What is my premium and how can I enroll?

The current guidance from the federal government says your dependents will pay $0 premium for COBRA. Since you are not eligible for the federal COBRA subsidy, you will have an option to enroll in regular COBRA (or Temporary COBRA Relief, if qualified) You may choose either to enroll effective April 1, 2021 or back to the date of your initial COBRA offer.

I lost coverage January 1, 2021 and I am eligible for the federal COBRA subsidy. My spouse is not eligible for the federal COBRA subsidy. Can my spouse still enroll in COBRA effective April 1, 2021?

Yes.

I lost coverage January 1, 2020 and received a COBRA offer, never enrolled, but I am not eligible for the federal COBRA subsidy. Can I still enroll in COBRA?

Yes. You can choose whether you want to enroll effective April 1, 2021 or back to January 1, 2020 when you initially lost coverage. You will be responsible for the full COBRA premium back to the date you choose to enroll.

Will my COBRA coverage really be free?

During the six-month period from April through September of 2021, participants (and family members) who are eligible for COBRA during that period and who qualify for the federal subsidy will pay $0 of the monthly COBRA premium. The Plan will charge participants and dependents $0 for COBRA and will bill the federal government for the COBRA premiums.


Covered Benefits

What benefits are covered under the $0 COBRA premium?

The COBRA subsidy is related to cost, not benefits. The benefits covered under the $0 COBRA premium are the same as those covered under regular, non-subsidized COBRA. 

What benefits are covered under the $0 COBRA premium?

The COBRA premium is related to cost, not benefits. The benefits covered under the $0 COBRA premium are the same as those covered under regular, non-subsidized COBRA.


COBRA Payments

How do I pay my COBRA premium?

You have different options for paying your COBRA premiums, as detailed here.

I am currently enrolled in COBRA effective April 1, 2021. How do I get the $0 COBRA premium?

The Plan has not charged you your April or May premium but has extended your coverage contingent on you completing the enrollment process. You will receive a notice and some forms to fill out from the Plan. You must follow the instructions and return the required information by May 15, 2021 to avoid any disruption to your coverage. After the Plan reviews the information, you have submitted, if you are determined to be eligible for the premium, it will continue to be automatically applied. If you have already paid any COBRA premium payments for any months for which you are determined to be eligible for the subsidy, those premium payments will be returned to you.

I already made COBRA payments for April. How will I receive the refund?

You will receive a notice and some forms to fill out from the Plan. You must follow the instructions and return the required information by May 15, 2021 to avoid any disruption to your coverage The Plan will review the information you have submitted and determine if you are eligible for the $0 subsidy for the premium payments that you already made. If you are eligible, those premium payments will be returned to you.


When COBRA subsidy ends

How long does the $0 COBRA premium last?

The premium will last for six months at most, from April 1, 2021, through September 30, 2021. The subsidy will end earlier if your maximum period of COBRA coverage (generally, 18 months) ends earlier than September 30, 2021. It will also end earlier if you become eligible for coverage under another group health plan or Medicare. You are required to notify the Health Plan if you become eligible for such coverage and would be subject to penalty if you fail to do so.

What happens when the $0 COBRA premium ends on September 30, 2021?

You will receive a notice with additional information from the Plan.  If you are still eligible for COBRA, you can pay the full cost of COBRA to continue the coverage after September 30. Alternatively, you can enroll in health coverage through the Affordable Care Act (ACA) Marketplace. For information, healthcare.gov.

Note: The extension of the above deadlines does not extend the maximum period of COBRA coverage to which you are entitled.


For more information

For the exact dates that will apply to your COBRA period, please log into your Benefits Manager.  

Want to review the COBRA Premium Subsidy from the Department of Labor?