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I am planning to quit my job and move to another company. This new company does not offer health insurance for the first 60 days of employment.

As I understand it, federal law requires employers with more than 20 employees to offer COBRA insurance to employees that lose coverage when they quit their job. This is expensive as I will have to cover the full cost of the premiums, I will not receive the employer paid portion. I would like to avoid paying this, or at least minimize my expenses.

It looks like I have 60 days to enroll in COBRA. After that period, I'll be eligible for insurance through my new employer. Can I just not enroll in COBRA and hope I don't need it? If I fall and break my leg, could I then go and enroll and be covered? The DOL site says the coverage is retroactive, so I expect that should be okay, but I'm not sure.

Is there any other risk with this? In the past creating a gap in insurance was dangerous because conditions could become pre-existing, but I think since Obamacare was passed that isn't legal. I don't have any prescriptions or any other persistent issues where I would expect to need a doctor visit.

In summary, am I able to not enroll until I need it, hoping that I don't need it? Are there any downsides I should be aware of?

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Yes, you should be able to elect COBRA coverage and avoid paying premiums before your 60 day waiting period is up.

Under the COBRA laws you have up to 60 days to elect COBRA. See Q8 at:

COBRA Q & A

It says:

If you are entitled to elect COBRA coverage, you must be given an election period of at least 60 days (starting on the later of the date you are furnished the election notice or the date you would lose coverage) to choose whether or not to elect continuation coverage.

So just defer your election until the 60 days expires. If you find that you need insurance during the 60 days, you then elect the coverage. Once you elect coverage you have another 45 days to make a payment. See Q15 at the same source as above where it says:

When you elect continuation coverage, you cannot be required to send any payment with your election form. You can be required, however, to make an initial premium payment within 45 days after the date of your COBRA election (that is the date you mail in your election form, if you use first-class mail). Failure to make any payment within that period of time could cause you to lose all COBRA rights. The plan can set premium due dates for successive periods of coverage (after your initial payment), but it must give you the option to make monthly payments, and it must give you a 30-day grace period for payment of any premium.

So this takes you do 60 + 45 days or 105 days which is well past your 60 day waiting period.

If you don't pay the COBRA premium by this time it will simply be cancelled.

The key point is to ELECT COBRA coverage at the last day of eligibility and then defer the paying of premiums until you are covered by your new plan.

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