COBRA (Consolidated Omnibus Budget Reconciliation Act) is a federal law that allows employees and their families to continue their employer-sponsored health insurance after a qualifying event such as job loss, reduction in hours, or other life changes. You keep the exact same plan, doctors, and network — but you pay the full premium yourself (both the employee and employer portions), plus up to a 2% administrative fee.
26 steps across 8 sections
1. Who Qualifies
- Employees (and their covered dependents) of private-sector employers with 20 or more employees
- Applies to group health plans including medical, dental, and vision
- Covers voluntary and involuntary job loss (quit, layoff, termination)
- Also triggered by: reduction in hours, divorce/legal separation, death of employee, dependent child aging out
2. Who Does NOT Qualify
- Employees terminated for gross misconduct (the only termination-based exclusion)
- Employees of companies with fewer than 20 employees (may qualify for state mini-COBRA instead)
- Employees of federal government (covered by separate federal law) or churches
- If the employer terminates the group health plan entirely (no plan = no COBRA)
3. The 102% Rule
- You pay 100% of the full premium (your share + what your employer used to pay) plus up to 2% administrative fee
- Total: up to 102% of the plan cost
4. Typical Monthly Costs (2026)
- The average employer pays ~75-80% of employee premiums; under COBRA you pay it all
- Annual COBRA cost for a family can exceed $18,000-$26,000
- Costs vary by plan design, geographic location, and employer
5. Payment Rules
- First payment due within 45 days of electing COBRA
- Subsequent payments due on the 1st of each month with a 30-day grace period
- Coverage is retroactive to the date of the qualifying event (no gap)
- Missing a payment = permanent loss of COBRA coverage (no reinstatement)
6. Standard Duration: 18 Months
- Applies to job loss and reduction in hours
- Starts from the date of the qualifying event (not the election date)
7. Extended Duration: 36 Months
- Divorce or legal separation from the covered employee
- Death of the covered employee
- Covered employee becomes entitled to Medicare
- Dependent child ceases to be a dependent under the plan
8. Disability Extension: 29 Months
- If you or a covered family member is determined disabled by Social Security within the first 60 days of COBRA
- Extends coverage from 18 to 29 months
- Employer can charge up to 150% of premium during months 19-29
Common Mistakes
- Assuming COBRA is your only option
- Not comparing costs
- Missing the 60-day election deadline
- Missing a monthly payment
- Not understanding retroactive coverage
Pro Tips
- The 60-day retroactive election is your biggest leverage
- Losing your job = SEP for both COBRA and ACA Marketplace
- COBRA is month-to-month
- Negotiate with your former employer
- If you're close to 65
Sources
- HealthCare.gov -- Options If You Lose Job-Based Coverage
- HealthCare.gov -- COBRA Coverage When Unemployed
- DOL -- FAQs on COBRA Continuation Health Coverage
- Aetna -- COBRA Insurance Guide
- Venteur -- What is COBRA Insurance? Benefits, Costs & Eligibility Guide 2026
- MoneyGeek -- COBRA Alternatives: Know Your Coverage Options in 2026
- 1099 Health Ins -- Guide to COBRA Health Insurance Alternatives 2026
- Taylor Benefits -- COBRA Costs 2026
- HealthCareInsider -- COBRA vs. ACA Marketplace When Leaving a Job
- Stride Health -- Lost Your Job? Compare COBRA vs. Marketplace
- OpenExamPrep -- COBRA vs ACA Marketplace 2026
- NY DFS -- COBRA FAQs