COBRA Management

The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) was passed to ensure that workers and their families continue to get health benefits coverage when their coverage through their employer ceases. The Federal Government has identified a specific set of events that qualify an employee for COBRA coverage.

Under COBRA, the normal period of coverage is either 18 or 36 months. An 18 month period of continuation coverage is available to covered employees and their spouses and dependents in cases where coverage has been lost due to the employee’s termination or reduction of hours. For employees who have been disabled, the limit increases to 29 months. In cases where the spouse and or dependents have lost coverage due to the entitlement to Medicare, divorce or legal separation, or death, the mandated coverage period is 36 months. This 36 month continuation period also applies to cases where dependent children reach the maximum age for coverage under an employer’s plan.

In addition to Federal Government requirements, several states have developed legislation that is similar to the federal version of COBRA. These laws typically require that a continuation of coverage option be included in group health policies, just like the federal version. However, some states specifically require that state mandated continuation coverage be offered only after the expiration of any Federal coverage period has expired. Advantage HRM supports these differing timing requirements through use of tables which allow different stages to be defined as well as through the Employee Claim Inquiry (QECL) COBRA activity monitoring logic.

This topic includes the following areas:

• Identifying COBRA Eligibility

• Generating COBRA Account Statements

• Looking Up COBRA Information