Workers grapple with losing jobs, health coverage

With many workers just one positive COVID-19 test from a furlough — even if they’re not the one infected — the ongoing pandemic poses another worry: What happens to that employerbased health coverage when the employer closes the business?

Simply losing a job, even temporarily, is bad enough, and the queue for unemployment benefits can seem to stretch beyond the horizon. But by one estimate, 28 million Americans also could have lost their employerbased health insurance because of the pandemic — basically doubling the number of uninsured in this country, according to the U.S. Census Bureau.

Ultimately, success at getting or maintaining health coverage may depend on a range of factors, starting with the generosity of your former (and, hopefully, future) employer.

So far, employers generally have been demonstrating “a great level of sensitivity” for their workers, says Yuletta Pringle, a human resources specialist with the Society for Human Resource Management in Alexandria, Va. Her data shows that employers often agree to keep furloughed workers on the company health plan for up to three months.

Even then, arrangements have to be made for the employee to cover their part of the monthly cost — something which previously had been simply deducted from their pay.

The employer may help with that, or they may defer the cost until the worker is back on the payroll, Ms. Pringle said. But it’s still an expense on an individual’s already-strained budget.

Aside from those cases, laidoff workers have three primary options for health insurance when someone experiences a triggering life event such as job loss: COBRA, the Affordable Care Act marketplace or

Care Act marketplace or medical assistance.

• COBRA, an acronym for the Consolidated Omnibus Reconciliation Act of 1985, allows a worker to temporarily continue health coverage under the employer’s plan — but the employee often must cover the full cost of that coverage, plus a 2% administrative cost. The Kaiser Family Foundation found that the total annual average cost of that coverage in 2019 was $7,012 for an individual and $20,599 for a family. That’s an expensive proposition that often is out of reach for the newly unemployed.

• For those suddenly out of work and without health coverage, the ACA marketplace is a more affordable safety net, offering stopgap coverage until you’re rehired or find another job.

Depending on where you live there may be a menu of plans, and premiums, to choose from. But lower-premium plans typically carry higher deductibles or limited coverage, making them more affordable only as long as you don’t need to file a major claim. You must apply within 60 days of losing your previous insurance.

UPMC offers ACA health plans in 53 of Pennsylvania’s 67 counties; Highmark, which has now returned to Fayette and Greene counties, also has extensive offerings in the region. A typical plan might have a monthly premium in the range of $350, plus copayments for doctor’s visits and prescription drugs, which might add another $50-$75 a month depending on the number of medications needed.

If the Affordable Care Act plans are too costly as well, short-term insurance plans offer coverage that may last a few months or up to one year. Those will be cheaper, but the coverage is more limited and, unlike ACA plans, people with a preexisting medical condition may be denied coverage.

• Eligibility for medical assistance such as the Medicaid program is based on income and the size of your household, but the application process is straightforward. Applications for this and other government programs are available on this state site.

There’s another consideration in choosing a new health plan: the possibility that you will have to wait for a period of time after enrolling before the coverage goes into effect.

That would not be an issue with COBRA

---because it just continues previous coverage from the employer.

And once a Medicaid application is processed and approved — which takes about 10-12 days — there is no waiting period for that program either. Eligibility will be retroactive to the date the application is submitted or even earlier in some circumstances.

But it may be a different story if you’re switching insurance plans.

Typically, coverage will start on the first of the month after you’re hired, as is the case with ACA plans, or in other cases perhaps an extra 30 days beyond that.

But the maximum, said Ms. Pringle, is a full 90 days.