COBRA election period - first payment

[Guest jlgic12]

I have a former employee who was covered under a large group self-funded plan that elected to continue coverage for her family during her COBRA election period. The election period has now elapsed. The 45 days from election date to make first COBRA premium payment has not yet elapsed, but the member now wishes to cover herself and husband only, as of the inception date of COBRA. Since COBRA coverage is not effective until premium is received, can the member do this? Where can I find specific language allowing/disallowing this very thing?

[leevena]

The person electing COBRA is entitled to continue coverage for the same dependents that were covered under the group plan, and if they wanted to cover less dependents, they can also do that.

I have not had a situation like yours, but I have to believe that you would be required to enroll the ee/sp under COBRA, even thought they elected "family" earlier.

The term "inception date of cobra" is confusing. What the ex-employee may be saying is that they want their coverage backdated to the their qualifying date. You are correct though about your idea of effective date being tied to receipt of the premium. However, the effective date will go backdated, not the date the administrator receives the premium check.

Hope this helps.

[jsb]

This just sounds like a request to drop the kids from coverage. If they had already made, say, 3 payments, and then sent in just enough for self and spouse, would you drop the kids for non-payment?

I would be inclined to continue whoever is being paid for based on your normal structure.

[Guest jlgic12]

I guess I was not clear.

What I am wanting to know is:

The employee elected family coverage, the election period has passed, & has not made first Cobra payment yet. The employee has two more weeks left of the 45-day period until first COBRA premium is due. The employee now wants to just pay for employee + spouse coverage, and only have employee+spouse coverage in effect as of COBRA start date. Is this a "can do"?

I am thinking that the employee would have to pay for the entire family, then drop the kids as of today and calculate first premium due as such, with future premiums being based on employee+spouse.

Comments? Sources?

[Kirk Maldonado]

I have researched this issue extensively and there is no definitive guidance on this point (that I could find).

[Guest jlgic12]

I have researched this issue extensively and there is no definitive guidance on this point (that I could find).

Thanks Kirk. That's what I ran into also.

[leevena]

Thanks Kirk. I just assumed that I could not find anything about this, so it's nice to know that others found nothing.

Again, my point/suggestion would be to enroll the ex-employee as a "EE+SP" unit even though they initially applied for a "family" unit. I go back to the intent of the law, which was to make coverage available to ex-employees. While an ex-employee cannot improve the coverage, i.e., go from single to family, they can decrease the coverage.

It just seems to me that if you deny enrollment, you are going against the intent of the law. Why get into a battle over this?

Just my thoughts.

[Guest jlgic12]

Thank you to everyone.