COBRA and Disability

[Chaz]

Employee is over 65 and entitled to Medicare. Employee was on short term disability but will shortly move to long-term disability. When this occurs, the employee will lose medical coverage. Employee does not currently intend to retire or otherwise terminate employment.

Has a COBRA qualifying event occurred because medical coverage was lost because of a reduction in hours (to 0)? Or is the employee not entitled to COBRA?

Any other considerations that I should be aware?

Thanks.

[Guest Ira Hayes]

The U. S. Supreme Court decision re Giessal vs. Moore and ensuing federal legislation (the acronym escapes me) clarify that the employee is entitled to COBRA for up to 18 months.

Employee is over 65 and entitled to Medicare. Employee was on short term disability but will shortly move to long-term disability. When this occurs, the employee will lose medical coverage. Employee does not currently intend to retire or otherwise terminate employment.

Has a COBRA qualifying event occurred because medical coverage was lost because of a reduction in hours (to 0)? Or is the employee not entitled to COBRA?

Any other considerations that I should be aware?

Thanks.

[Mary C]

Ira - I don't think the question was can someone have COBRA who has other coverage, such as Medicare, which is what the Geisel case refers to, but rather has he even had an event for COBRA.

Yes, reducing hours to "0" can be considered a COBRA event, but then the questions arise such as - If you consider the event when he went on leave and reduced his hours to "0", what would you call his coverage from that date to the date he goes on LTD? Would you include this in his 18 months of COBRA? Also, however you treat this individual, you will need to do the same for any employee who goes on leave in the future.

[Guest jrzgrl]

The question I would ask first is how have you treated employees in a similar situation in the past. What does your leave policy state in regards to being out on leave and how long you keep an employee as active while out on disability? I'm curious as to why this person's hours are at 0 now, but not while they were on STD, as Mary indicates in her post. Does your company have to follow the guidelines of FMLA? Bottom line, consistency is key.

[Chaz]

The hours were 0 when the person was on STD but the employee had medical coverage until going on LTD so there was no qualifying event when STD started and thus there is no COBRA obligation. My question is whether a qualifying event occurred when LTD started.