Employee Benefits Question of the Week: Who qualifies and when for COBRA?

QUESTION: COBRA allows individuals to temporarily continue their employer-sponsored health care coverage when certain qualifying events occur that would otherwise end the coverage. So who qualifies for COBRA and when?

ANSWER:    Only qualified beneficiaries are entitled to elect COBRA. A qualified beneficiary is an employee covered by an employer-sponsored group health plan on the day before a “qualifying event” takes place that would trigger COBRA rights, as well as that employee’s spouse, former spouse and dependent children if they were covered by the plan. Dependent children include adopted children.

Domestic partners are not considered spouses for purposes of federal law, including COBRA. Group health plan sponsors that offer domestic partnership coverage may offer COBRA-like rights to domestic partners, but they are not required to do so.

Qualifying events include the following:

  • a covered employee’s termination of employment or reduction of the hours of employment
  • the covered employee becoming entitled to Medicare
  • divorce or legal separation from the covered employee
  • the death of the covered employee
  • a dependent child ceasing to be a dependent under the generally applicable requirements of the plan

For more information on COBRA visit the the CMS page FAQ on COBRA.  You can also find an employer and employee guide on the DOL site.

 

Sources:

https://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/cobra_qna

https://blog.ifebp.org/index.php/who-qualifies-for-cobra

https://www.dol.gov/sites/dolgov/files/legacy-files/ebsa/about-ebsa/our-activities/resource-center/publications/an-employees-guide-to-health-benefits-under-cobra.pdf

 

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s