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COBRA 101

" Qualifying Events" Under COBRA

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7/19

COBRA only applies when a qualifying event occurs.  Qualifying events for:

Employees:

  • Voluntary or involuntary termination of  a covered employee's employment  for any reason, unless the employee is let go because of  gross misconduct.
  • An employee on leave under the Family and Medical Leave Act (FMLA) notifies an employer of an intent not to return to work. (FMLA leave is not a qualifying event under COBRA.)
  • Voluntary or involuntary reduction of the employee's number of hours below the minimum number of  hours required to qualify for group health coverage.
  • An employer goes through a bankruptcy proceeding under Title 11 of the United States Code.

Spouses:

  • Voluntary or involuntary termination of  a covered employee's employment  for any  reason, unless the employee is let go because of  gross misconduct.
  • Covered employee is subject to voluntary or involuntary reduction of  number of  hours below the minimum number of hours required to qualify for group health coverage.
  • Covered employee and spouse become divorced or legally separated.
  • A covered employee becomes entitled to Medicare benefits and no longer qualifies for the group plan.
  • The death of a covered employee.

Domestic Partners or Significant Others:

  • COBRA does not apply to significant others or domestic partners even if they have been covered under the plan.

Dependent Children:

  • Loss of dependent child status under the plan rules which basically means the child becomes older than the age limit described in the health insurance policy.
  • Voluntary  or involuntary termination of  a covered employee's employment for  any  reason, unless the employee is let  go because of  gross misconduct;
  • Covered employee is subject to voluntary  or involuntary reduction of  number of hours below the minimum number  of  hours required to qualify for group health coverage.
  • The death of a covered employee

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