List of Sections
§ 54.4980B-1COBRA in general.
§ 54.4980B-2Plans that must comply.
§ 54.4980B-3Qualified beneficiaries.
§ 54.4980B-4Qualifying events.
§ 54.4980B-5COBRA continuation coverage.
§ 54.4980B-6Electing COBRA continuation coverage.
§ 54.4980B-7Duration of COBRA continuation coverage.
§ 54.4980B-8Paying for COBRA continuation coverage.
List of Questions
§ 54.4980B-1COBRA in general.
Q-1: What are the health care continuation coverage requirements contained in section 4980B of the Internal Revenue Code and in ERISA?
Q-2: What is the effective date of §§ 54.4980B-1 through 54.4980B-8?
§ 54.4980B-2Plans that must comply.
Q-1: For purposes of section 4980B, what is a group health plan?
Q-2: For purposes of section 4980B, what is the employer?
Q-3: [Reserved]
Q-4: What group health plans are subject to COBRA?
Q-5: What is a small-employer plan?
Q-6: [Reserved]
Q-7: What is the plan year?
Q-8: How do the COBRA continuation coverage requirements apply to cafeteria plans and other flexible benefit arrangements?
Q-9: What is the effect of a group health plan's failure to comply with the requirements of section 4980B(f)?
Q-10: Who is liable for the excise tax if a group health plan fails to comply with the requirements of section 4980B(f)?
§ 54.4980B-3Qualified beneficiaries.
Q-1: Who is a qualified beneficiary?
Q-2: Who is an employee and who is a covered employee?
Q-3: Who are the similarly situated nonCOBRA beneficiaries?
§ 54.4980B-4Qualifying events.
Q-1: What is a qualifying event?
Q-2: Are the facts surrounding a termination of employment (such as whether it was voluntary or involuntary) relevant in determining whether the termination of employment is a qualifying event?
§ 54.4980B-5COBRA continuation coverage.
Q-1: What is COBRA continuation coverage?
Q-2: What deductibles apply if COBRA continuation coverage is elected?
Q-3: How do a plan's limits apply to COBRA continuation coverage?
Q-4: Can a qualified beneficiary who elects COBRA continuation coverage ever change from the coverage received by that individual immediately before the qualifying event?
Q-5: Aside from open enrollment periods, can a qualified beneficiary who has elected COBRA continuation coverage choose to cover individuals (such as newborn children, adopted children, or new spouses) who join the qualified beneficiary's family on or after the date of the qualifying event?
4.4980B-6Electing COBRA continuation coverage.
Q-1: What is the election period and how long must it last?
Q-2: Is a covered employee or qualified beneficiary responsible for informing the plan administrator of the occurrence of a qualifying event?
Q-3: During the election period and before the qualified beneficiary has made an election, must coverage be provided?
Q-4: Is a waiver before the end of the election period effective to end a qualified beneficiary's election rights?
Q-5: Can an employer or employee organization withhold money or other benefits owed to a qualified beneficiary until the qualified beneficiary either waives COBRA continuation coverage, elects and pays for such coverage, or allows the election period to expire?
Q-6: Can each qualified beneficiary make an independent election under COBRA?
54.4980B-7Duration of COBRA continuation coverage.
Q-1: How long must COBRA continuation coverage be made available to a qualified beneficiary?
Q-2: When may a plan terminate a qualified beneficiary's COBRA continuation coverage due to coverage under another group health plan?
Q-3: When may a plan terminate a qualified beneficiary's COBRA continuation coverage due to the qualified beneficiary's entitlement to Medicare benefits?
Q-4: [Reserved]
Q-5: How does a qualified beneficiary become entitled to a disability extension?
Q-6: Under what circumstances can the maximum coverage period be expanded?
Q-7: If health coverage is provided to a qualified beneficiary after a qualifying event without regard to COBRA continuation coverage (for example, as a result of state or local law, the Uniformed Services Employment and Reemployment Rights Act of 1994 (38 U.S.C. 4315), industry practice, a collective bargaining agreement, severance agreement, or plan procedure), will such alternative coverage extend the maximum coverage period?
Q-8: Must a qualified beneficiary be given the right to enroll in a conversion health plan at the end of the maximum coverage period for COBRA continuation coverage?
54.4980B-8Paying for COBRA continuation coverage.
Q-1: Can a group health plan require payment for COBRA continuation coverage?
Q-2: When is the applicable premium determined and when can a group health plan increase the amount it requires to be paid for COBRA continuation coverage?
Q-3: Must a plan allow payment for COBRA continuation coverage to be made in monthly installments?
Q-4: Is a plan required to allow a qualified beneficiary to choose to have the first payment for COBRA continuation coverage applied prospectively only?
Q-5: What is timely payment for COBRA continuation coverage?