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- Health Benefits Advisor for Employers

Consolidated Omnibus Budget Reconciliation Act (COBRA)

Qualifying Events

Before a group health plan must offer COBRA coverage, a qualifying event must occur for a qualified beneficiary. The group health plan is not required to act until it receives an appropriate notice of such a qualifying event. The events below are qualifying events only if they would cause a loss of coverage under the plan. For example, if an employee becomes entitled to Medicare but the Medicare entitlement does not cause a loss of health coverage, then the Medicare entitlement is not a qualifying event.

You, the employer, are required to notify the plan administrator if the qualifying event is:

  • A termination or reduction in hours of employment of the covered employee;
  • The death of the covered employee;
  • The covered employee's becoming entitled to Medicare; or
  • If the plan provides retiree health coverage, the commencement of a proceeding in bankruptcy with respect to the employer.

The covered employee or one of the qualified beneficiaries is responsible for notifying the plan administrator if the qualifying event is:

  • Divorce;
  • Legal Separation; or
  • A child's loss of dependent status under the plan.

Note regarding multiemployer plans: Multiemployer plans may have different rules for providing COBRA notices. First, a multiemployer plan may choose not to require employers to provide qualifying event notices, and instead to have the plan administrator determine when a qualifying event has occurred. A multiemployer plan also may adopt longer time limits for the qualifying event notice or the election notice. Any special multiemployer plan rules must be set out in the plan's documents, including the SPD.