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COBRA Continuation of Coverage

Notices Required of Employers or Plans

Initial Notice: A group health plan (or employer) must provide an initial notice describing the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) rights to each covered employee and spouse of the employee (if applicable) at the time coverage under the plan begins. The plan may send a single notice addressed to a covered employee and the covered employee's spouse at their joint address, provided the plan's latest information indicates that both reside at that address. Alternatively, a plan may send separate notices to an employee and the employee's spouse.

The plan must send a separate initial notice to a spouse under the following circumstances: an employee receives his or her initial notice at the workplace (in-hand delivery of the initial notice to an employee is permissible but does not constitute delivery to the spouse); the employer or plan has knowledge that the spouse resides at a different address than the employee; a spouse's coverage under the plan begins at a different time than the covered employee's coverage.

Other Notices: Other notice requirements are triggered for employers and plan administrators when a qualifying event occurs. Employers must notify plan administrators of a qualifying event within 30 days after an employee's death, termination, reduced hours of employment, or entitlement to Medicare (when an employee's Medicare entitlement results in loss of plan coverage for the employee's dependents). (An employee or other qualified beneficiary must notify the plan administrator of certain other events within 60 days of the event, but the employer or plan administrator is responsible for informing them of that requirement. Click on "Notices Required of Qualified Beneficiaries" on the left navigation bar and view, in particular, the "Important Note.")

Plan administrators, upon receiving notice of a qualifying event, must provide an election notice to qualified beneficiaries of their right to elect COBRA coverage. Because qualified beneficiaries have independent election rights, plan administrators should either include a separate election notice for each qualified beneficiary in a single mailing that is addressed to both the employee and spouse, or, if a single notice is sent, it should clearly identify all qualified beneficiaries covered by the notice and explain each person's separate and independent right to elect COBRA coverage.

A plan administrator must always send separate election notices to qualified beneficiaries who do not reside at the same address if the different addresses are known to the plan administrator. A notice sent to the spouse is treated as a notification to all qualified dependent children residing with the spouse at the time the spouse's notification is sent by the plan administrator. Notices must be provided in person or by first class mail within 14 days after the plan administrator receives notice that a qualifying event has occurred.

Model Notices: The Employee Benefits Security Administration (EBSA), U.S. Department of Labor, has issued final rules implementing private sector COBRA notice requirements (69 Federal Register 30084 – 30112, May 26, 2004). The final rules include a general COBRA rights notice that is issued when coverage under the plan begins (FR page 30099), and a notice of COBRA rights that is issued following a qualifying event (FR page 30106). The EBSA website also includes separate presentations of each notice. (See related links outside CMS below.)

Use of the model notices is not required. However, they are noted here because they may be helpful to state and local government employers and their plan administrators in developing their (public sector) COBRA rights notices. State and local government employers and their plan administrators should ensure that their COBRA rights notices are provided on a timely basis and apprise individuals of all requirements for which an individual is responsible in order to elect and maintain COBRA continuation coverage for the maximum period.

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Related Links Outside CMSExternal Linking Policy

Model General Notice

Model Election Notice

 

Page Last Modified: 09/15/2008 8:19:16 AM
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