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When COBRA Strikes, There’s Help

Volume CVI, No. 5May, 2006

If you’ve fallen off your health insurance and need help paying your COBRA premiums, you may be in luck.

In 2004, after years of lobbying, a coalition of entertainment unions — including Local 802 — succeeded in getting a COBRA subsidy bill passed and signed into law.

The upshot of the law — called the New York State COBRA Assistance Program — is that if you are an entertainer and you fall off your health insurance, the state may pay up to 50 percent of your COBRA costs to help you keep your health insurance, for up to one year.

COBRA is the federal law that allows workers who lose their group health insurance — by being laid off, for instance — to pay to keep their health coverage for a temporary period of time (usually 18 months).

Under the new state law, the state of New York will pick up some of the COBRA tab for eligible entertainers.

Local 802 members might take advantage of this new law as follows.

Let’s say a member subs a Broadway show and earns the union’s health plan. But then the Broadway show closes and the member is low on union work and falls off the union’s plan. The way COBRA works is that the member can keep the plan by paying out of pocket for a temporary amount of time. Under the new law, the state may pick up half of the tab, for up to a year.

In early March, Local 802’s Health Benefits Fund sent a letter to all members who might be eligible for this program.

To be eligible, you must meet each of the following requirements:

  • You must be a New York State resident;
  • You must be eligible for — or currently receiving — COBRA continuation coverage through the Local 802 health benefits plan;
  • Your income must not exceed a maximum of $1,984 per month for a one-person household up to a maximum of $4,700 per month for a five-person household;
  • You must not already be receiving continuation assistance via this program;
  • You must not be eligible for Medicare; and
  • You must not be eligible to participate in employer-sponsored health coverage.

For more information, check out the Web site of the New York State Insurance Department at www.ins.state.ny.us/cobra/cobra_entertainment.htm. You may also obtain an application from the Heatlh Benefits page of our website, or you can request a copy of the application by sending an e-mail to hpb@local802afm.org.

Your completed application should be sent directly to the following address: New York State Continuation Assistance Program, P.O. Box 7184, Albany, New York 12224-0184.

Upon receipt of your application, the state Insurance Department will review your application for eligibility and notify you as to whether you are eligible for premium subsidies through the program.

Please notify Local 802’s Health Benefits Fund as soon as you receive your notification of eligibility.

Note that until your application is approved by the state Insurance Department, you must keep paying your full COBRA premium!

Once the state Insurance Department has received your application, and it is determined that you are eligible for the program, the state will pay half of your COBRA bill for up to 12 months. The state will make payments directly to Local 802’s Health Benefits Fund.

For general questions relating to this program, please contact Local 802’s Health Benefits Fund at (212) 245-4802 or the Consumer Services Bureau at the New York Department of Insurance at (800) 342-3736.