COBRA Qualifying Event

[Guest Ira Hayes]

Must an employee on group health coverage (subject to COBRA) currently who refuses to complete a mandatory online health risk assessment during open enrollment be offered COBRA?

The rationale for your answers is most welcome.

[oriecat]

No. The COBRA regs specify what are Qualifying Events.

26CFR54.4980B-4

(b) An event satisfies this paragraph (b) if the event is any of the

following--

(1) The death of a covered employee;

(2) The termination (other than by reason of the employee's gross

misconduct), or reduction of hours, of a covered employee's employment;

(3) The divorce or legal separation of a covered employee from the

employee's spouse;

(4) A covered employee's becoming entitled to Medicare benefits

under Title XVIII of the Social Security Act (42 U.S.C. 1395-1395ggg);

(5) A dependent child's ceasing to be a dependent child of a covered

employee under the generally applicable requirements of the plan; or

(6) A proceeding in bankruptcy under Title 11 of the United States

Code with respect to an employer from whose employment a covered

employee retired at any time.

[JanetM]

You can't offer COBRA unless you fire them or they terminate over this mandatory HRA.

[Chaz]

Actually, an employer can offer "COBRA-like" coverage. But the employee is not ENTITLED to receive COBRA.

[Mary C]

I didn't think you could condition enrollment in a health care plan upon completion of EOI or health assessment under HIPAA.

[Guest Ira Hayes]

Why not?

I didn't think you could condition enrollment in a health care plan upon completion of EOI or health assessment under HIPAA.

[leevena]

MaryC....An employer can require a health risk assessment as a condition for eligibility to the health plan. I do not remember the name, but there was a case in Virgina (a book store or something like that) that was involved in such a dispute and the courts found in favor of the employer.

[Chaz]

MaryC....An employer can require a health risk assessment as a condition for eligibility to the health plan. I do not remember the name, but there was a case in Virgina (a book store or something like that) that was involved in such a dispute and the courts found in favor of the employer.

I read somewhere awhile ago that it might be a violation of the ADA to "require" (by providing a disincentive not to) participation in a health risk assessment if the health risk assessment makes "disability-related" inquiries. I believe what I read said that only de minimis incentives such as a key chain or a coffee mug are permitted.

Now this issue has raised its ugly head again. Employer wants to require employees who do not complete an HRA to only be eligible for an HDHP and not its PPO plans. Does anyone have an update to this thread? Is it possible that the standard under the ADA will be the same as under HIPAA (i.e., 20%) for bona fide wellness programs?