Qualifying Event Crisis

[Guest JMD67]

Employee terminated on 4/28/03

Benefits being covered until 5/30/03

Employee turns 65 on 5/2/03

Has spouse who turns 65 on 7/19/03

Spouse has a QE on the day husband turns 65?

Employee has a QE on the last day of coverage?

Then spouse becomes a multiple qualifyer on that last day of coverage?

--- does that make her eligible for extended months?

--- what about when she turns 65 two months later?

I'm not quite sure how to handle this one, I'm confused.

[Guest AJK0020]

If I were you, I would start in "Mandated Health Benefits- The COBRA Guide" published by Thompson Publishing Group. Sec. 1121 give direction to the actual QE as the term date of the employee, Sec. 1252 for Medicare as a second QE for spouse (which may not be the case here because the former employee may not be cut off of COBRA benefits due to the date of election of continuation Sec. 1314 "When elections are made"). I would seek some counsel before heading into this cloud of gray.

[Guest kgeiger]

Once he turned 65, I think that she would be entitled to 36 months from the date of the termination of employment, which was the initial qualifying event. This is because enrollment in Medicare for the employee operates as a secondary qualifying event. However, if she enrolls in Medicare after electing COBRA, her COBRA coverage would cease.

[Guest jreddi]

A QBs' turning 65 does not necessarily make it a qualifying event, first, second or otherwise. What does make it a qualifying event is their entitlement to Medicare.

If the employee (and spouse) have already signed up for Medicare and are entitled to benefits prior to electing COBRA then there is no qualifying event beyond the employee (and spouse) losing coverage because of termination of employment. If, however, the employee has not signed up for Medicare and does so after he elects COBRA, then he no longer is eligible for COBRA. In this case, the QB (the spouse) would be eligible for the additional 18 months, for a total of 36 months from the original qualifying event.

This hinges on the wording in the original law "first becomes covered under another plan..." that the Supreme Court addressed in Geissal.

John