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COBRA qualifying events are different from "life events" that impact health coverage or employee benefits. In this article, we take a closer look at events and which employees or dependents they impact, as well as how long a person can be enrolled in COBRA continuation coverage. A COBRA qualifying event is such that it causes the qualified beneficiary to lose coverage under the plan. For example, an employee getting married, is not a COBRA qualifying event. Rather, it is considered a life event. The marriage of the employee to the new spouse does not cause a loss of coverage. The following graphic demonstrates the maximum periods of coverage that continuation coverage must be offered for the different types of qualifying events that impact employees and their covered family members when it comes to COBRA compliance. These employees and covered dependents shown below are called "qualified beneficiaries" if they experience a COBRA event, and this means that they are entitled to elect continuation coverage when an event occurs. With COBRA employee benefits, it is important for employers, agents, and insurance carriers to be aware that in certain circumstances, the qualified beneficiaries entitled to 18 months of continuation coverage may become entitled to an extension. For example, the disability extension under COBRA, would allow a qualified eligible individual to extend from 18 to 29 months of COBRA continuation coverage.
Or, as another example, certain state legislation automatically allows eligible individuals from eligible plans to extend COBRA coverage beyond the 18-month maximum for certain event types. Medicare entitlement, yet another example, may allow an individual's spouse to continue COBRA coverage for up to 36 months from the original qualifying event date depending on special circumstances. (See also our post on Medicare & COBRA). In summary, when COBRA qualifying events occur, it's important for Plan Administrators, HR Professionals, Agents of Record, and Insurance Company personnel to understand the Federal and State-specific requirements for employee rights under COBRA or state continuation coverage rules in order to ensure that Plan Participants receive the coverage and benefits to which they are entitled.
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