If a participant has other coverage available to them can they stay on Cobra (non subsidy)

[Guest furiousfurrball]

If a participant is enrolled in Cobra (not through a ARRA subsidy) and they have other coverage available to them, either through their employer or their spouse's employer can the cobra employer drop them from coverage? How do you monitor whether or not your cobra particpants have other coverage?

[Guest Benefits Broker CO]

COBRA can be continued if the former employee is eligible for other group coverage. The former employer cannot drop them from coverage due.

[oriecat]

54.4980B-7 Question 2

Q-2: When may a plan terminate a qualified beneficiary's COBRA

continuation coverage due to coverage under another group health plan?

A-2: (a) If a qualified beneficiary first becomes covered under

another group health plan (including for this purpose any group health

plan of a governmental employer or employee organization) after the date

on which COBRA continuation coverage is elected for the qualified

beneficiary and the other coverage satisfies the requirements of

paragraphs (b), ©, and (d) of this Q&A-2, then the plan may terminate

the qualified beneficiary's COBRA continuation coverage upon the date on

which the qualified beneficiary first becomes covered under the other

group health plan (even if the other coverage is less valuable to the

qualified beneficiary). By contrast, if a qualified beneficiary first

becomes covered under another group health plan on or before the date on

which COBRA continuation coverage is elected, then the other coverage

cannot be a basis for terminating the qualified beneficiary's COBRA

continuation coverage.

(b) The requirement of this paragraph (b) is satisfied if the

qualified beneficiary is actually covered, rather than merely eligible

to be covered, under the other group health plan.

© The requirement of this paragraph © is satisfied if the other

group health plan is a plan that is not maintained by the employer or

employee organization that maintains the plan under which COBRA

continuation coverage must otherwise be made available.

(d) The requirement of this paragraph (d) is satisfied if the other

group health plan does not contain any exclusion or limitation with

respect to any preexisting condition of the qualified beneficiary (other

than such an exclusion or limitation that does not apply to, or is

satisfied by, the qualified beneficiary by reason of the provisions in

section 9801 (relating to limitations on preexisting condition exclusion

periods in group health plans)).

(e) The rules of this Q&A-2 are illustrated by the following

examples:

Example 1. (i) Employer X maintains a group health plan subject to

COBRA. C is an employee covered under the plan. C is also covered under

a group health plan maintained by Employer Y, the employer of C 's

spouse. C terminates employment (for reasons other than gross

misconduct), and the termination of employment causes C to lose coverage

under X 's plan (and, thus, is a qualifying event). C elects to receive

COBRA continuation coverage under X 's plan.

(ii) Under these facts, X 's plan cannot terminate C 's COBRA

continuation coverage on the basis of C 's coverage under Y 's plan.

Example 2. (i) Employer W maintains a group health plan subject to

COBRA. D is an employee covered under the plan. D terminates employment

(for reasons other than gross misconduct), and the termination of

employment causes D to lose coverage under W 's plan (and, thus, is a

qualifying event). D elects to receive COBRA continuation coverage under

W 's plan. Later D becomes employed by Employer V and is covered under V

's group health plan. D 's coverage under V 's plan is not subject to

any exclusion or limitation with respect to any preexisting condition of

D.

(ii) Under these facts, W can terminate D 's COBRA continuation

coverage on the date D becomes covered under V 's plan.

Example 3. (i) The facts are the same as in Example 2, except that D

becomes employed by V and becomes covered under V 's group health plan

before D elects COBRA continuation coverage under W 's plan.

(ii) Because the termination of employment is a qualifying event, D

must be offered COBRA continuation coverage under W 's plan, and W is

not permitted to terminate D 's COBRA continuation coverage on account

of D 's coverage under V 's plan because D first became covered under V

's plan before COBRA continuation coverage was elected for D.