Stunned by news of losing their jobs, laid-off employees often are asked to quickly make a highly complex decision: What should they do about health insurance?
Should they opt to continue their employer coverage by shelling out big bucks for a policy known as COBRA? Seek an individual policy in the open market? Go without insurance?
In this struggling economy, growing numbers of workers face these tough decisions. They often must compare COBRA with dozens, even hundreds, of options in the individual market -- and do so in a short time.
So what's best? "The simple answer is that it all depends, " says Santiago Leon, who sells health insurance for ACC Insurance Brokers in Miami.
Experts say the general rule is that if you're older and/or have major health problems, go for COBRA. If you're younger and in good health, opt for an individual policy.
But many say there's no alternative at all. "I was offered COBRA, " says Alfonso Urcuyo, who lost his job several months ago with a healthcare company in Cooper City.
"But it was more than $1,000 a month for a family, and who can afford that when they're not working?" asks Urcuyo. "We don't have any coverage now. So far it's been pretty good. Knock on wood. We haven't really had any big health problems."
Experts say that his decision is understandable, but is the most risky. "The big mistake people make is that they say, 'Well, I'm pretty healthy right now. If I get sick, then I'll get a policy, ' " says Craig Thomas of Blue Cross Blue Shield of Florida. "But that's exactly the wrong thing to do."
Because once you've had a heart attack or get cancer, you can be denied a policy or not allowed coverage for "a preexisting condition."
"The main thing is don't allow a gap in coverage once you're in the insurance system, as long as you have options, " says Thomas. "Once you have a period when you're uninsured and try to get back, that's when you have a problem. That's why it's dangerous for people to roll the dice."
The reason: State law says that if you have a health policy, an insurer can't dump you, although it can raise the rates. If you have no coverage, an insurer can reject you for many reasons.
Some people losing their jobs might have the opportunity to opt for retiree insurance, which represents yet another option, but most must decide between COBRA, buying a policy on the individual market or becoming uninsured.
Here's a quick look at the two main options:
This acronym stands for Consolidated Omnibus Budget Reconciliation Act, which is the law behind the insurance but doesn't explain at all what it is.
This federal law requires that anyone who had health insurance with a company with more than 20 employees is entitled when they leave to keep their coverage for up to 18 months, or sometimes longer if certain conditions apply. A similar state law covers companies with under 20 employees.
The hitch is the departing employee must pay the whole premium -- the portion they paid and the portion the employer paid, plus a two percent administration fee.
This is steep. For major South Florida employers, this can run $300 or $400 per month for an individual, $700 or so for a couple and about $1,100 for a family.
Those numbers, in fact, are a main reason why companies are outsourcing to India or relying more on temporary and part-time workers: That way employers avoid healthcare costs.