“COBRA” stands for Consolidated Omnibus Budget Reconciliation Act and is a federal law to help those who experience a job loss or other qualifying event, to continue their existing medical, dental, and vision insurance coverage for a limited period (typically 18 months).

Are dental benefits covered under COBRA?

Yes. Dental coverage is included under COBRA along with medical and vision benefits.

However, you can’t choose new coverage or switch to a different plan from the one you had prior to your change in employment. If, for example, you had a medical and dental plan while employed but not a vision plan, you can keep one or both plans under COBRA – but you couldn’t add a vision plan.

How do I qualify for COBRA-based dental benefits?

Businesses with 20 or more employees must offer COBRA coverage for those who qualify.

To be eligible for COBRA coverage, you must have been enrolled in your employer's dental plan while working, and the dental plan must continue to be in effect for active employees.

You qualify for COBRA coverage if:

• Your employment has ended, either voluntarily (resignation or retirement) or by your employer (for any reason other than your gross misconduct) resulting in your loss of employee health coverage; or
• The number of hours you work per week was reduced to the point that you no longer receive benefits resulting in your loss of employee health coverage

If you are a spouse or dependent on the plan, you may also qualify for COBRA if:

• Coverage is provided by someone who experiences either of the events noted above; or
• You are a spouse who divorces or files for legal separation from the employee whose coverage you receive; or
• You are the spouse of an employee who dies.

What coverage do I receive under COBRA? 

You will receive the same coverage you had while you were employed, as will your spouse and/or dependents if applicable.

However, COBRA coverage may be terminated if any fees or premiums are left unpaid. It may also be terminated if you qualify for Medicare or get a job that offers coverage during the period of COBRA coverage. 

How do I sign up for COBRA dental coverage?

If you are a member of a Delta Dental of South Dakota plan, your employer will notify us if you lose your dental plan due to one of the qualifying events. You will be notified of your self-pay options and the dental plan’s monthly costs. You will then have up to 60 days to decide whether to purchase continued coverage.

Each qualified beneficiary – spouse or dependent(s) - has a separate right to elect COBRA coverage. For example, the employee's spouse may elect coverage even if the employee does not. Continuation coverage may be elected for only one, several, or for all dependent children who are qualified beneficiaries. A parent may elect to continue coverage on behalf of any dependent children. The employee or the employee's spouse can elect continuation coverage on behalf of all of the qualified beneficiaries.

How do I pay for COBRA insurance?

Under COBRA, you pay your entire premium. This amount is often higher than when you were employed, since your employer is no longer sharing the cost.

An administrative fee may also apply. In general, expect to pay more for COBRA coverage due to fees and an unshared premium – however, keep in mind that premiums cannot exceed the total cost of your coverage.

In some cases, it may be less costly to enroll in a new individual dental plan than pay the premium and fees to keep your prior coverage under COBRA. It’s a good idea to weigh your options, understand coverage amounts, and research individual plans before deciding one way or the other.

To learn more about our dental plans click here.

We can help!

These are the highlights of COBRA-based coverage, but there are other important details about qualifying events, qualifying for coverage, length of coverage, and termination of coverage, depending on the circumstances.

Contact us if you have any questions about COBRA dental benefits. Call us toll free at 877-841-1478. We’re happy to help!