Who is entitled to benefits under COBRA?

Asked 10-Jan-2018
Updated 31-Jan-2024
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Overview:

The Consolidated Omnibus Budget Reconciliation Act (COBRA) presents sure people with the right to keep their institution medical insurance coverage underneath particular occasions once they could otherwise lose it. 

Who is entitled to benefits under COBRA

 

 

Eligibility for COBRA advantages is normally extended to the following people:

  • Employees:

Qualified employees who had been covered with the aid of an enterprise-backed organization health plan and enjoy a qualifying occasion that results in a loss of insurance Qualifying occasions for employees encompass termination of employment for reasons other than gross misconduct, a discount on work hours, or eligibility for Medicare.

  • Spouses:

Spouses of included employees who have been included under the business enterprise's organization health plan at the time of the qualifying occasion This consists of spouses in the case of divorce or criminal separation from the blanketed employee.

  • Dependent Children:

Dependent kids of protected employees who had been included under the corporation's group fitness plan at the time of the qualifying occasion. This consists of natural kids, stepchildren, adopted youngsters, and kids born at some stage in the period of COBRA coverage.

  • Retirees:

Retirees who have been included by way of the agency's organization fitness plan and revel in a qualifying occasion, including the organization's financial disaster or Medicare entitlement.

  • Alternative Coverage:

Individuals who could have been eligible for COBRA but declined coverage initially because of becoming eligible for other group fitness plan insurance (including via a brand new business enterprise) and then lose that alternative insurance due to a qualifying occasion.

  • Surviving Dependents:

Surviving spouses and established kids of a deceased protected worker.

 

Individuals eligible for COBRA blessings can be required to pay the full premium, consisting of the organization's contribution, plus a small administrative price.

 

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