Insurance Qualifying Event Cobra
In this case a cobra qualifying event occurs due to the reduction of hours if it causes the beneficiaries to lose their group health plan coverage.
Insurance qualifying event cobra. In order for a qualifying event to occur there must be both a triggering qualifying event listed above and a resulting loss in plan coverage 177 for example an employer s termination of its health plan will not require the employer to offer cobra coverage because while there is a loss of plan coverage no triggering event occurred that. The consolidated omnibus budget reconciliation act of 1985 cobra is a federal law that requires most employers to provide employees spouses and dependent children who lose group health benefits due to a qualifying event with an opportunity to continue group health coverage for a limited period of time. In either case the qualifying life event would trigger a special enrollment period that would make you eligible to select a new individual insurance policy through the state marketplace. Qualifying events include life events that allow a policyholder to change coverage types as well as.
The irs states that a qualifying event must have an impact on your insurance needs or change what health insurance plans that you qualify for. Second qualifying events may include the death of the covered employee divorce or legal separation from the covered employee. The final rule allows qualified beneficiaries to elect cobra continuation coverage at any time throughout the outbreak period after being notified. There is never a second qualifying event cobra extension available for the covered employee.
The employer has 30 days after the employee s reduction of hours to notify the group health plan administrator about the qualifying event. A spouse and dependent children who already have cobra coverage and then experience a second qualifying event may be entitled to a total of 36 months of cobra coverage. Where the spouse or dependent s experiences a second qualifying event the cobra maximum coverage period extends from 18 months to 36 months. Cobra establishes only the minimum requirements for continuation coverage.
Deadline to notify plan administrator of cobra qualifying event. Cobra second qualifying event. What is the extension of coverage. 18 to 36 month period second qualifying event.
However in the likely event that the employer chooses not to subsidize cobra the cobra premium cannot exceed 100 percent of the cost of the group health plan for similarly situated individuals who have not incurred a qualifying event including both the portion paid by employees and any portion paid by the employer prior to the qualifying. An event that triggers a change in a policyholder s insurance coverage. The type of qualifying event determines who the qualified beneficiaries are for that event and the period of time that a plan must offer continuation coverage.
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