Qualified Events (QEs) Explained

What is a Qualifying Event?

A Qualifying Event—commonly referred to as a QE—is a specific situation that causes someone to lose their group health plan. When that happens, COBRA rules may allow them to continue coverage temporarily.

These events are clearly defined, and each one determines which family members are eligible for continuation, and for how long. It’s worth noting that while COBRA sets the minimum standards, some plans may extend those timelines or contribute toward the cost of coverage.

For Covered Employees: Two Main Triggers

If you’re the employee listed on the health plan, two qualifying events apply—so long as they lead to a loss of coverage:

• Employment ends for any reason except gross misconduct.
  
• Your hours are reduced below the threshold required for coverage.

In both cases, COBRA continuation coverage must be offered.

For Spouses and Dependents: A Few More Situations

A spouse or dependent child can also become eligible for COBRA if they lose coverage due to one of these events:

• The employee’s job ends (again, not for gross misconduct).
  
• The employee’s hours are significantly reduced.
  
• The employee becomes eligible for Medicare.
  
• Divorce or legal separation from the employee.
  
• The employee passes away.
  

Each of these events impacts eligibility differently, but all may trigger the option to extend group health coverage under COBRA.

For Dependent Children: One Additional Event

There’s one more situation for dependent children: aging out of coverage.

Most plans must cover children until age 26. After that, if the plan no longer considers them eligible as dependents, COBRA can provide a continuation option—helping to avoid an unexpected loss of healthcare.

Your Plan Might Offer More

COBRA rules create a baseline, but your employer’s plan could offer more generous terms—longer timelines, partial premium coverage, or additional notices. Always check with your benefits administrator to understand the specifics of your plan.