U.S. Department of Labor
Health Benefits Advisor for Employers
Consolidated Omnibus Budget Reconciliation Act (COBRA)
Does your group health plan have reasonable procedures in place for how the covered employee or qualified beneficiary can notify the plan of the above qualifying events?
Qualifying Events - Plan Procedures for Employees and Qualified Beneficiaries to Provide Notice
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.
The group health plan is required to have reasonable procedures in place for how the covered employee or qualified beneficiary can notify the plan administrator of the above qualifying events. The procedures must give covered employees and qualified beneficiaries at least 60 days to give notice after the latest of:
- When the qualifying event occurs;
- When loss of coverage occurs; or
- The date on which the covered employees or qualified beneficiaries are informed of their responsibility to provide notice.
The procedures must describe how, and to whom, notice should be given, and what information must be included in the qualifying event notice. If one person gives notice of a qualifying event, the notice covers all qualified beneficiaries affected by that event.
If a group health plan does not have reasonable procedures for how to provide these notices, qualified beneficiaries are permitted to give notice (either written or oral) to the person or unit that handles the employer's employee benefits matters. If the plan is a multiemployer plan, or if the plan is one to which more than one unaffiliated employer contributes, notice can also be given to the joint board of trustees, association, committee, or other similar group administering the plan; and if the plan is administered by an insurance company (or the benefits are provided through insurance), notice can be given to the insurance company.
