If you elect continuation coverage, coverage that is offered must be identical to the coverage available under the plan currently to similarly situated active employees and their families (usually this is the same coverage you had immediately before the qualifying event) .
Length of COBRA Continuation Coverage
You also have the right, while receiving continuation coverage, the same benefits, options and services that a participant or beneficiary in the same situation is currently receiving under the plan, such as the right during an open enrollment period choose from several coverage options available. Also be subject to the same rules and limits that would apply to a participant or beneficiary in the same situation as co-payment requirements, deductibles and coverage limits. The plan’s rules for filing claims for benefits and to appeal any denial regarding a claim are applicable.
Changes to COBRA Plan
Any changes to the terms of the plan that is applicable to similarly situated active employees and their families will also apply to qualified who are receiving continuation coverage under COBRA beneficiaries. If a covered employee him or adopts a child born during a period of continuation coverage, the child is automatically considered a qualified beneficiary receiving continuation coverage. You must submit an inquiry to your plan in order to get the rules to incorporate your child to continuation coverage under those circumstances.
Length of COBRA Continuation Coverage
COBRA requires continuation coverage extends from the date of the qualifying event for a limited period of 18 or 36 months. The term which should be available continuation coverage (the “maximum period” of continuation coverage) depends on the type of qualifying event that gave rise to rights under COBRA. A plan, however, may provide longer periods of coverage beyond the maximum period required by law.
When the qualifying event is the end of employment or reduction of hours of work of a covered employee, qualified beneficiaries are entitled to a maximum of 18 months of continuation coverage.
COBRA Qualifying Event
When the qualifying event is the end of employment or reduction of hours the employee and the employee became entitled to Medicare benefits less than 18 months before the qualifying event, COBRA coverage for the employee’s spouse and dependents may be force until 36 months after the date on which the employee became entitled to Medicare benefits. For example, if a covered employee becomes entitled to Medicare benefits eight months before the date of expiry of their employment (termination of employment is the qualifying event under COBRA) COBRA coverage for your spouse and children would be valid for 28 months (36 months minus 8 months).
For all other qualifying event, qualified beneficiaries are entitled to a maximum of 36 months of continuation coverage.
Early Cancellation of COBRA
A group health plan may terminate continuation coverage before the end of the maximum period for any of the following reasons:
- The premiums are not paid in full in a timely manner.
- The employer ceases to maintain a group health plan.
- A qualified beneficiary begins receiving coverage under another group health plan after electing continuation coverage, provided that such plan does not impose an exclusion or limitation that affects a pre-existing condition of the qualified beneficiary.
- A qualified beneficiary becomes eligible for Medicare benefits after electing continuation coverage.
- A qualified beneficiary engages in conduct that would justify the plan in terminating coverage of a participant or beneficiary in the same situation not receiving continuation coverage (such as fraud).
Other Information about Length of COBRA Continuation Coverage
If canceled continuation coverage early, the plan must provide the qualified a notice of such cancellation beneficiary.