COBRA provides that qualified employees and dependents in the groups listed below who were not previously able to continue on a group health plan may now elect to continue on the group health plan. Qualified employees and dependents are:
- Employees: Termination of employment (including involuntary termination for any reason other than gross misconduct); or a reduction in number of hours worked.
- Dependents: Divorce or legal separation; the employee's death; or an active employee's decision to drop out of the plan upon his/her entitlement to Medicare.
- Dependent Children: Loss of status as a dependent for any reason (e.g., attainment of maximum age, marriage, etc.).
If an employee becomes ineligible by virtue of (a) above, that employee (and his/her then covered dependents) must be offered continuation for the period beginning on the date coverage would otherwise cease and ending on the earliest of:
- the last day of the plan month for which the employee makes timely payment of any required premium; or
- the date on which the group health plan is ended (and not replaced); or
- with respect to each employee and dependent, the date that person becomes covered under another group health plan or becomes entitled to Medicare; or
- the date 18 months after the date continuation begins.
If an employee's dependents become eligible by virtue of (b) or (c) above, such dependents must be offered continuation for the period beginning on the date coverage would otherwise cease and ending on the earliest of:
- the last day of the plan month for which the dependents make timely payment of any required premium; or
- the date on which the group health plan is ended (and not replaced); or
- with respect to each dependent, the date that person becomes covered under another group health plan or becomes entitled to Medicare; or
- the date 36 months after the date continuation begins.
The following provision of the law providing for continuation of benefits will also apply:
- During the period of continuation, qualified employees/dependents will be treated as if normal plan coverage had not ceased.
- Employer will give general and specific written notice to employees/dependents as required.
- Employee or dependent will give proper written notice to the employer when a dependent qualified.
- The employee/dependent continuing coverage is responsible for the premium.
COBRA provisions that affect group health plans will be coordinated with Medicare coverage as per existing or modified law.
Previous to COBRA, patients were not charged for medical care provided by the Veterans Administration and Military Hospitals. Thus coverage under group health plans was excluded. Group health plans must reimburse the Federal government for VA/Military Hospital care. Such reimbursement will be made only to the extent permitted by the plan.
Date of Adoption/Revision:
August 11, 1986
August 10, 1987
August 1992
August 1995
June 1998
June 2001
June 2004
July 2007
July 2013
October 2016
