Mayelana nokulahlekelwa umshuwalense wakho wempilo esekelwe emsebenzini? Ucabanga nge- COBRA , kodwa ungaqiniseki ukuthi yikuphi okungcono, i-COBRA noma i- Obamacare ? (I-Obamacare ingenye igama elilodwa lomsebenzi wokunakekelwa okunganakekelwayo). Impendulo ixhomeke esimeni sakho, kodwa yilapho i-COBRA ne-Obamacare iqhathanisa.
Uhlelo olufanayo lwezempilo olubhekiselele ohlelweni lwezempilo oluhlukile
Uma ukhetha i-COBRA, ukhokha ukuqhubeka nokwaziswa ngaphansi kwe-plan yemshwalense yempilo eqinisekisiwe efanayo nomqashi osuvele unayo.
Uyazi ukuthi kusebenza kanjani nokuthi yini ongayilindela. Ukuphela kwekhava lokufunda elihilelekile kuhilelekile ukuthi ufunde nini futhi kanjani ukwenza izinkokhelo zakho ze-COBRA premium.
Uma ukhetha uhlelo lwezempilo lwe-Obamacare kusuka ekushintsheni komshuwalense wezempilo wombuso wakho (noma ngaphandle kokushintshaniswa, lapho izinhlelo futhi zihambisana ne-ACA), uzobe ushiya uhlelo lwakho oludala futhi uzoba nezinhlelo ezintsha eziningana ongakhetha kuzo. Uzobe uthenga uhlelo emakethe ngayinye, ngokuphambene nemakethe axhaswe ngumqashi (ngokuvamile okubhekwa njengengewona iqembu neqembu). Ngakho uzodinga ukutadisha ukuze uqonde ukuthi uhlelo lwakho olusha lwezempilo lusebenza kanjani uma luhlobo oluthile lwepulani kuneyakho endala. Isibonelo, uma uhlelo lomqashi wakho luyi-PPO kodwa uhlelo lwakho olusha lwe-Obamacare yi- EPO , kuzodingeka uqonde ukuthi zihluke kanjani ukuze ukwazi ukusebenzisa uhlelo lwakho olusha ngokuphumelelayo.
Uma uqhubeka uhlelo lwakho lwamanje ngaphansi kwe-COBRA, uyazi ukuthi udokotela wakho uzoba inethiwekhi ngoba awuguquli uhlelo lwakho lwezempilo.
Uma ukhetha uhlelo olusha lwe-Obamacare esikhundleni, kuzomele uqiniseke ukuthi udokotela wakho use-inethiwekhi ngecebo lakho elisha, noma kuzodingeka ushintshe odokotela. Kuzodingeka uhlole ukuthi imishanguzo yakho yemithi yesigqebhezana ihlanganiswe ngaphansi kwesicelo sakho semithi yesilwane esisha, noma kufanele ukhokhele ngaphandle kwe-pocket.
Lokhu kuyiqiniso ngisho noma uhlelo olulodwa olukhethile luhlinzekwa yinkampani yomshuwalense efanayo eyanikeza uhlelo lwakho oluxhaswe ngumqashi.
Isibonelo, umqashi wakho angase abe necebo elihlinzekwa yi-Blue Cross Blue Shield inshurensi esifundazweni sakho, futhi ungase uthathe isinqumo sokushintshela ohlelweni olulodwa oluhlinzekwa yi-Blue Cross Blue Shield. Kodwa uhlelo lwakho olusha lungase luhluke ngokuphelele kusuka kuhlelo lwakho lomdala. Izinzuzo, inethiwekhi yomhlinzeki, uhlu lwezidakamizwa ezihlanganisiwe, uhlobo lwepulani (i-HMO, i-PPO, i-EPO, njll) -ngakho konke kungahluka kakhulu phakathi kwemakethe ngayinye kanye nemakethe exhaswe ngumqashi, ngisho nalapho ubheka inkampani efanayo yomshuwalense.
Ukukhokha i-Premium Egcwele ngokuthola Imali Yokusiza Ukuze Ukhokhe
Uma ukhetha ukuqhutshwa kokuqhubeka kwe-COBRA, uzokhokha imali ekhokhwayo yenyanga ngayinye yale mali, kanye nemali yokuphatha ye-2% (khumbula ukuthi i-premium ephelele isho ukuthi uyingxenye oyikhokhela ngaphezu kwengxenye umqashi wakho akhokha ngayo, okungenzeka yingxenye enkulu ye-premium). Azikho izinsizakalo zokusiza ukukhokhela izinkokhelo ze-COBRA , futhi ziyabiza.
Uma ulahlekelwa i-COBRA futhi uthenge umshuwalense wakho wezempilo kusuka ekushintsheni komshuwalense wezempilo esikhundleni sakho, ungase ufanelekele uxhasomali ukusiza ukunciphisa amaphrimiyamu akho ngenyanga.
Ngaphezu kwalokho, ungase ufanelekele umxhaso ukuze unciphise ukuphuma kwakho kwepokhethi noma ukunciphisa ukukhishwa kwezimali zakho, ukukhokhelwa kwezimali kanye nokuqinisekiswa kwezimali . Lezi zinsizakalo zitholakala kuphela kumshuwalense wezempilo owathengiwe nge-Affordable Care Act yokushintshwa komshuwalense wezempilo esifundazweni sakho (uma uthenga uhlelo lwe-ACA oluvumelanisiwe ngaphandle kwezokushintshanisa, awukwazi ukuthola noma yikuphi ukusizwa).
Zonke lezi zinsizakalo zisekelwe kumholo wakho. Uma uhola kabanzi, imali yakho engaphansi izoba. Uma uhola okuningi, kungenzeka ukuthi awufanelekele umxhaso. Kodwa uma imali yakho ingenayo, cishe uzofaneleka ukuthola usizo.
Ukuba nelungelo lesibili lokukhetha
Uma ufaneleka ku-COBRA , unesikhathi esilinganiselwe sokubhalisa.
Iwashi iqala ukukhawula usuku lomcimbi oshukumisayo okwenze ukuthi ufaneleke ku-COBRA, ngokwesibonelo, ngosuku ohlukanisile ngalo noma owenziwe ngalo. Uma ungenzi lutho ngaphambi kwesikhathi esinqunyiwe, uzolahlekelwa ithuba lakho.Awutholi ithuba lesibili.
Uma ulahlekelwa yomshuwalense wakho wempilo esekelwe emsebenzini, uzokwazi ukuthola isikhathi sokubhalisa esikhethekile ekushintsheni komshuwalense wezempilo wombuso wakho (noma ohlelweni lomakethe olunikezwa ngaphandle kokushintshaniswa, uma lokho okuthandayo), kungakhathaliseki ukuthi ukuqhubeka kwe-COBRA kuyatholakala kuwe. Njengenkathi yekhetho le-COBRA, le nkathi ekhethekile yokubhalisa isikhathi sinciphile. Kodwa-ke, uma ungaphuthelwa isikhathi esiphezulu, uzoba nelungelo lesibili lokubhalisela umshuwalense wezempilo ekushintsheni ngesikhathi sokubhalisa ngonyaka ovulekile njalo ekwindla. Asikho isikhathi sokubhalisa esivulekile se-COBRA.
Ubude besikhathi
I-COBRA ayihlali kuze kube phakade. Yenzelwe njengenhlelo yokukuthola kuze kube yilapho uvikela olunye ukufakwa. Kuye ngokuthi yiluphi uhlobo lomcimbi okwenze ukuthi uvumeleke ku-COBRA, ukukhishwa kwakho kwe-COBRA kuzohlala ezinyangeni ezingu-18 kuya kwezi-36. Ngemuva kwalokho, kuzodingeka uthole enye umshuwalense wezempilo.
Ungabhalisela uhlelo lwe-Obamacare (imakethe ngayinye) yonyaka wekhalenda ( ukuvala noma ukuvala ukushintshaniswa ). Uma ubhalisa ngesikhathi sokubhalisa esikhethekile, ungashintsha ohlelweni olusha ngesikhathi sokubhalisa sonyaka ovulekile. Uma ufuna ukuqhubeka nohlelo lwakho olusha okungaphezulu konyaka futhi umshwalense wakho uyaqhubeka ukunikela, ungawuvuselela. Uma umshwalense wakho evala uhlelo, uzokwazi ukubhalisela uhlelo oluhlukile ekushintsheni kwakho, noma ngqo nomshuwalense wezempilo uma ukhetha ukukhishwa kokushintshana (khumbula ukuthi izinsizakalo azitholakali uma uthenga uhlelo ngaphandle ukushintshanisa).
Isikhathi Somusa Wokukhokha Premium
I-COBRA ayivumeli amathuba okubili. Uma usuphelile ekukhokhweni kwe-premium yakho yokuqala, uzolahlekelwa ilungelo lakho lokubhalwa kwe-COBRA futhi ngeke ukwazi ukuwubuyisela. Uma usuphelile ekukhokhweni kwe-premium ngenyanga ngaphandle kokukhokha kwakho kokuqala, ukukhokhelwa kwakho komshuwalense wezempilo kuzokhanselwa ngalolo suku. Uma wenza inkokhelo yakho kungakapheli isikhathi somusa wezinsuku ezingu-30, ukukhishwa kwakho kwe-COBRA kungabuyiselwa. Kodwa-ke, uma ungenzi inkokhelo phakathi nesikhathi somusa, ngeke ukwazi ukuthola umshwalense wakho wezempilo we-COBRA.
Uma lokhu kwenzeka kuwe, uzobe uboshwe ngempela. Ukulahlekelwa kwekhasimende lakho le-COBRA ngokuhluleka ukukhokha ama-premium akho akukwenzeli isikhathi sokubhalisa esikhethekile ekushintsheni komshuwalense wezempilo, noma ngaphandle kokushintshaniswa. Kuzodingeka ulinde kuze kufike ukubhaliswa okuvulekile ekwindla (Novemba 1 kuya kuDisemba 15 ezindaweni eziningi) ukubhalisa ohlelweni lwe-Obamacare; uzoba engozini yokungaqinisekisiwe okwamanje.
Nakuba izinkampani zomshuwalense ezithengisa umshuwalense wezempilo empilweni yomshwalense wezempilo wombuso wakho zilindele ukukhokhwa ngesikhathi ngasinye inyanga zonke, isikhathi somusa sokukhokha sekwephuzile sikwedlula kune-COBRA kwabanye abantu. I-Affordable Care Act ivumela isikhathi sezinsuku ezingu-30 somusa ngezinkokhelo ezisheshayo kuzo zonke izinhlelo zezempilo ezithengiswa ngezingxoxo. Kodwa lokhu kunwetshwa ezinsukwini ezingu-90 uma uthola usizo lwemali yomshuwalense wezempilo (nakuba kufanele ukhokhelwe ngokugcwele ekupheleni kwezinsuku ezingu-90; akukuvumeli ukuthi ube njalo izinyanga ezintathu ngemuva kwama-premium akho).
Ubani iNdikimba Ebusayo?
Izinhlelo ze-COBRA nomshuwalense wezempilo ezisekelwe emisebenzini zilawulwa yiMnyango Wezabasebenzi. Uma unenkinga enkulu ngecebo lakho le-COBRA, ngemuva kokulandela inqubo yezikhalazo nezikhalazo, ungaqeda ukubhekana noMnyango Wezabasebenzi ngomzamo wokuxazulula le nkinga.
Izinhlelo zezempilo ezithengiswa ngomshuwalense wezempilo wombuso wakho zilawulwa yilowo nalowo mhlaba. Uma unenkinga enkulu ngecebo lakho lempilo esekelwe ekushintshaneni, ngemuva kokulandela inqubo yezikhalazo kanye nezikhalazo, ungaqeda ukubhekana noMnyango Womshuwalense wombuso wakho noma uMnyango Womshuwalense noma uMkhomishinari Womshuwalense ukuxazulula le nkinga.
> Imithombo:
> UMnyango Wezabasebenzi. Izinhlelo Zempilo Nezinzuzo: Ukuqhutshwa Kwezempilo - I-COBRA.
> Kaiser Family Foundation. 2017 Survey Health Benefits Survey. Ngo-September 19, 2017.