Can you give us general rules for COBRA? Our employee is retiring at 62. Does he get COBRA for 18 or 36 months? His wife is 58. How long does she get COBRA?
The COBRA coverage period for the retiring employee and his spouse is 18 months. The following is a general description of COBRA duration rules.
The COBRA coverage period for the employee, spouse, and dependent children is 18 months when the qualifying event is:
- The covered employee’s termination of employment for any reason other than gross misconduct
- The covered employee’s reduction of hours of employment
The COBRA coverage period for a spouse and dependent children is 36 months when the qualifying event is:
- Death of the covered employee
- Divorce or legal separation of the covered employee from his or her spouse
- The covered employee becoming entitled to Medicare benefits
The COBRA coverage period for a dependent child is 36 months when the qualifying event is:
- A dependent child ceasing to be a dependent under the plan’s rules
There are two circumstances when a COBRA beneficiary entitled to the 18-month coverage period is eligible for an extension:
- If a COBRA beneficiary is disabled and meets certain requirements, all related COBRA beneficiaries are entitled to an 11-month extension.
- An 18-month extension may be available for a spouse or dependent child who experiences a second qualifying event.
COBRA coverage may be terminated early when:
- A COBRA beneficiary fails to make timely payment of COBRA premiums, becomes covered under another group health plan, or becomes covered under Medicare after electing COBRA
- The employer ceases to provide any group health plan to any employee
- A COBRA beneficiary whose disability extended the coverage period is determined not to be disabled before the end of the extended period
- A COBRA beneficiary’s coverage can be terminated for cause (e.g., fraudulent claims) on the same basis as would apply to non-COBRA beneficiaries under the plan.