COBRA and Special Enrollment

[Guest Brenda N.]

A COBRA participant has medical only coverage. He has been enrolled in his wife's dental plan. His wife retired and enrolled in a retiree plan. They both have dental under the retiree plan. He is now wanting to add dental coverage under COBRA saying that he has special enrollment rights because of the loss of the wife's active dental plan. Does anyone think this is a special enrollment event? I've read the regulations, but it's not clear to me.

[KIP KRAUS]

I don’t understand why he wants to add COBRA dental if he has dental under his wife’s plan. In any event, I would say his ability to add COBRA dental under your plan has expired. It is my understanding that once you deny COBRA coverage you can’t pick it up later regardless of any event.

[Steve72]

I disagree with the second part of Kip's post. A COBRA participant must be granted the same rights as employee-participants. If there is a special enrollment right, then the COBRA participant must be given the opportunity to enroll.

That said, I don't know whether there's a "loss" of coverage here. IS there any difference between the wife's active and retiree dentla plans? If the retiree plan is inferior, there could be a loss of coverage granting a special enrollment right.

[mroberts]

I would say the ex-employee would have to wait until your companie's next open enrollment to pick up dental coverage since he is not losing any coverage. Where do the regs say anything about having an inferior plan taking the place of the superior plan being a qualifying event to change benefits?