COBRA is an acronym for the federal law, the Consolidated Omnibus Budget Reconciliation Act of 1986.  The law is designed to allow eligible employees and/or their covered dependents to continue certain health-related group benefits when coverage is lost for a number of reasons.

Note: The law does not require that COBRA coverage is made available if an employee is terminated for “gross misconduct.”

Responsibilities

• Notify your employer within 60 days of a divorce, legal separation or child’s no longer being eligible for coverage, (for example, because of passing the maximum age for coverage).
• Notify your employer in writing within 60 days of the later of the notification of COBRA option or loss of coverage date that you wish to take COBRA coverage, and then pay within 45 days of that date all back premiums. (No coverage will be in force until the money is paid, but the payment of the money will reinstate coverage back to the Qualifying Event date if paid in a timely manner.)
• Pay the applicable monthly premium in a timely manner (i.e., within 30 days of the due date) even if you do not receive a bill.
• Provide proof of disability status from the Social Security Administration (if you or a family member is trying to qualify for possible disability COBRA extension to 29 months). Note: You must notify the plan administrator within 60 days of the formal determination by the Social Security Administration of a disability.
• Keep the employer who’s sponsoring the group coverage you’re continuing informed of your current mailing address.

Qualifying Events

For Employee / Former Employee:

• Reduction in your hours of employment or the termination of your employment (for reasons other than gross misconduct on your part).

For Spouse of Employee / Former Employee:

1. The death of your spouse.
2. A termination of your spouse’s employment (for reasons other than gross misconduct), or reduction in your spouse’s hours of employment.
3. Divorce or legal separation from your spouse.
4. Your spouse becomes entitled to Medicare benefits (if a loss in coverage occurs).
5. Your spouse is a retiree and your spouse’s employer files for Chapter 11 reorganization.

For Dependent Child of Employee / Former Employee:

1. The death of a parent.
2. The termination of a parent’s employment (for reasons other than gross misconduct) or reduction in a parent’s hours of employment.
3. Parent’s divorce or legal separation.
4. A parent becomes entitled to Medicare benefits and would lose group coverage (if a loss in coverage occurs).
5. The dependent ceases to be a “dependent child” under the group health plan.
6. The parent is a retiree and the parent’s employer files for Chapter 11 reorganization.

Note: If, as an employee, you go out on a qualified leave under the Family and Medical Leave Act of 1993, special rules apply. The COBRA Qualifying Event will not start until you notify the company, during the leave period, that you will not be coming back or if you do not return at the end of the leave period.

Under the law, the employee or a family member has the responsibility to inform the Human Resource Department of your employer (or former employer) of a divorce, legal separation, or a child losing dependent status under the group health plan within 60 days of this Qualifying Event. There is also a 60-day notification requirement for informing the Plan Administrator of a disability award from the Social Security Administration to qualify for the possible disability extension.