# How do I extend my health insurance after a layoff? (COBRA bridge)

> Counteroffer · Answers · severance
> Source: https://trycounteroffer.com/answers/health-insurance-after-layoff-cobra


**Short answer:** You have three options for health insurance after a layoff: (1) COBRA, which continues your employer plan for up to 18 months but at full cost ($500-$2,500/month for family coverage); (2) ACA Marketplace plans, often cheaper if you qualify for subsidies based on reduced income; (3) Spouse's employer plan if a spouse is employed. Negotiate an employer-paid COBRA bridge in your severance: 3 months for ICs, 6 months for directors, 9-12 months for VP+, up to 18 months for executives. This is one of the easiest concessions to win because the cash cost is small relative to the value to you.

## On this page
- [The COBRA basics](#the-cobra-basics)
- [What COBRA costs](#what-cobra-costs)
- [Marketplace alternatives](#marketplace-alternatives)
- [Negotiating COBRA bridge in severance](#negotiating-cobra-bridge-in-severance)
- [Practical timing](#practical-timing)

## The COBRA basics

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) lets former employees continue their employer health insurance plan for up to 18 months after qualifying events including involuntary termination. Key facts:

- Applies to employers with 20 or more employees
- 18-month maximum for most terminations; 29-36 months in certain disability or family scenarios
- Coverage continues at the same plan with the same network and benefits
- You pay the full premium plus a 2% administrative fee (the employer is no longer subsidizing the premium)

You have 60 days from the qualifying event to elect COBRA, and once elected, you have another 45 days to pay the first premium. Coverage is retroactive to the date of the original event if you elect within the window.

For state-mandated extensions (mini-COBRA in some states), coverage can run longer, but rules vary.

## What COBRA costs

The cost of COBRA is the full premium that previously was split between employer and employee:

- **Individual coverage**: Typically $500-$900/month
- **Family coverage**: Typically $1,500-$2,500/month

These numbers vary significantly by plan, region, and family size. Check your last benefits enrollment summary for the actual full premium amount.

The shock for most employees is that what cost them $200/month at work becomes $1,800/month on COBRA. The employer was subsidizing roughly 80-90% of the premium during employment.

## Marketplace alternatives

If you can't afford COBRA (or COBRA is more expensive than a comparable Marketplace plan), look at:

**ACA Marketplace plans:**
- Available year-round during Special Enrollment Period triggered by loss of employer coverage
- Premiums often dramatically lower than COBRA for similar coverage
- Subsidies available based on annual household income (which often includes the layoff year as low-income)
- Different network than your employer plan, which may matter if you have specific providers

**Spouse's employer plan:**
- Job loss is a qualifying event allowing mid-year enrollment in spouse's plan
- Often the cheapest option if available
- Same network and benefits as the spouse's existing coverage

**Short-term plans:**
- 1-12 months of coverage in most states
- Cheap but limited (often excludes pre-existing conditions, prescription drugs, maternity)
- Use only as a true bridge for healthy individuals

**Medicaid:**
- Income-based; check eligibility if income drops to qualifying levels
- Free or very low cost
- Coverage varies by state

## Negotiating COBRA bridge in severance

The most common severance health benefit is an employer-paid COBRA bridge: the employer pays your COBRA premiums (or a cash equivalent) for a defined number of months after separation.

Standard benchmarks by role:

| Role | Typical COBRA bridge |
|---|---|
| Individual contributor | 3 months |
| Manager | 3-6 months |
| Director | 6 months |
| VP | 9-12 months |
| SVP / EVP | 12-15 months |
| C-Suite | 15-18 months |

Why this is easy to negotiate:

- The cash cost to the employer is small relative to other severance items
- The agreement is administratively simple (employer just pays the COBRA premium directly)
- Many companies routinely include COBRA bridges for senior leaders; getting it added is asking for parity, not exception

Counter language to propose:

> "Company shall pay the full COBRA premium for Employee's continued health coverage (including any family coverage at the level Employee maintained during employment) for [N] months following the separation date. In the alternative, at Employee's election, Company may provide a one-time cash payment equivalent to [N] months of COBRA premium, grossed up for tax."

The gross-up matters because COBRA premium reimbursements from former employers are taxable income, while continued employer payment of COBRA premiums was previously a pre-tax benefit.

## Practical timing

Two timing items to manage:

**COBRA election deadline.** Once you receive the COBRA notice from the plan administrator, you have 60 days to elect. Don't sit on this. Even if you plan to use a Marketplace plan instead, electing COBRA preserves your option to switch if you need treatment immediately.

**Special Enrollment Period for Marketplace.** Loss of employer coverage triggers a Special Enrollment Period at the federal Marketplace (healthcare.gov) or your state exchange. The window is 60 days from loss of coverage. Apply during this window to access plans.

**Coordination with severance.** If your severance includes a COBRA bridge for 6 months, plan to switch to a Marketplace plan or other coverage when the bridge ends. Don't get caught uninsured at the bridge end date.

## What to do next

If you want a delivered review of your severance agreement, including specific language to add an employer-paid COBRA bridge, we deliver one in 24 hours for $199. See [Severance Review](https://trycounteroffer.com/severance).

## Sources

- Consolidated Omnibus Budget Reconciliation Act of 1985 (29 USC § 1161 et seq.)
- Affordable Care Act (Pub. L. 111-148)
- IRS Publication 502 (medical expense deductions)
- HHS Marketplace data at healthcare.gov

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## Related answers
- [What's negotiable in a severance agreement?](https://trycounteroffer.com/answers/whats-negotiable-in-severance)
- [How do I negotiate a severance offer?](https://trycounteroffer.com/answers/how-to-negotiate-severance)
- [How much severance should I get?](https://trycounteroffer.com/answers/how-much-severance-should-i-get)

## Get your contract reviewed
If you want a delivered review of your specific document with cited authority and counter language, see https://trycounteroffer.com/severance.

Last updated: Sun May 31 2026 00:00:00 GMT+0000 (Coordinated Universal Time)

_Counteroffer is a contract analysis service, not a law firm. This page is informational, not legal advice._