Health Benefits Advisor for Employers

Consolidated Omnibus Budget Reconciliation Act (COBRA)

Does your group health plan provide COBRA coverage that is the same coverage currently available to similarly situated individuals under the plan who are not receiving COBRA coverage?

• Yes
• No

Types of Benefits Offered Under COBRA

Continuation coverage under COBRA must be the same coverage that is currently available under your group health plan to similarly situated individuals who are covered under the plan and not receiving COBRA coverage. (Generally, this is the same coverage that a qualified beneficiary had immediately before the qualifying event.)

In other words, a qualified beneficiary receiving COBRA coverage must receive the same benefits, choices, and services that a similarly situated participant or beneficiary is currently receiving under the plan, such as the right during an open enrollment season to choose among available coverage options. The qualified beneficiary will also be subject to the same rules and limits that would apply to a similarly situated participant or beneficiary, such as co-payment requirements, deductibles, and coverage limits. The plan's rules for filing benefit claims and appealing any claims denials also apply.

Any changes made to the plan's terms that apply to similarly situated active employees and their families will also apply to qualified beneficiaries receiving COBRA coverage. If a child is born to or adopted by a covered employee during a period of COBRA coverage, the child is automatically considered to be a qualified beneficiary entitled to receive COBRA coverage. The plan must allow the child to be added to the COBRA coverage once notice is given to the plan administrator.