We are going to talk about qualifying events that can trigger COBRA. Qualifying events are certain events that cause an individual to lose group health coverage.

Recognizing when a qualifying event has occurred is essential to complying with COBRA. The type of qualifying event determines who the qualified beneficiaries are and the amount of time the plan must offer coverage to them under COBRA.  

A qualified beneficiary is an individual who was covered by an employer-sponsored group health plan on the day before a qualifying event occurred, including the employee, the employee's spouse, and the employee's dependent child. Any child born to, or placed for adoption with, a covered employee during a period of COBRA coverage is automatically considered a qualified beneficiary.

Qualifying events for employees, spouses, and dependent children generally include:

  • The voluntary or involuntary termination of the covered employee's employment for any reason other than gross misconduct; and

  • A reduction in the number of hours of the covered employee's employment.

Additional qualifying events for spouses and dependent children include:

  • The covered employee becoming entitled to Medicare;

  • A divorce or legal separation of the spouse from the covered employee; and

  • The death of the covered employee.

A dependent child may also experience a qualifying event due to loss of dependent child status under the plan rules.

Topics: COBRA

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