COBRA & Social Security Disability Extension Explained

Under COBRA, there are certain rules that allow eligible individuals with disabilities (or their qualifying dependents) to get an extension on the regular 18-month coverage period to 29 months total. In order for an individual to qualify for the extension of COBRA insurance coverage due to disability, a qualified beneficiary must be deemed disabled by the Social Security Administration (SSA) and meet several other criteria.

​COBRA Participants who have been deemed disabled by the SSA should notify the Plan Administrator of the disability determination right away. The plan should have rules set that indicate how the notice should be provided, including contact details. Plans generally require that the notice of disability determination from the SSA should be provided to the Plan Administrator (or designated contact) within the first 18 months of the COBRA continuation coverage and within 60 days of the later of:

1. When the individual received the SSA Notice of Award or;
2. When the COBRA continuation coverage began.

The premium payment requirements can be different during the extended 11 months of coverage as Plans are allowed to charge up to 150% of the premium to the Participant(s). 

The premium payment requirements can be different during the extended 11 months of coverage as Plans are allowed to charge up to 150% of the premium to the Participant(s).

Ultimately, employees need to be provided with all of the details pertaining to these types of COBRA disability extensions, especially requirements regarding how and when they must apply if they wish to receive extended coverage. This is one of many reasons why it is imperative that employers furnish thorough, up to date, and accurate Initial Rights Notices (General COBRA Notice) to newly insured employees and their spouses within 90 days of enrollment into group health benefits. Another notice that should describe the disability extension rules in detail is the COBRA Notice of Right to Elect (COBRA Election Notice) issued when a qualifying event occurs.

Even with thorough notices, we understand that the regulatory side of the COBRA disability determination can be quite tricky to navigate so we’ve published a Comprehensive Guide for Employers on the Disability Extension and COBRA. You can access it at no cost here.

Download White Paper Here!

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