401 Chaos Posted April 2, 2024 Posted April 2, 2024 Spouse received longer COBRA coverage period at employee's termination than the employee's 18-month coverage period because of employee's Medicare coverage prior to termination. Is there any restriction on the covered spouse adding the former employee back to coverage (here just the dental plan) during the next open enrollment. It seems the spouse (as a qualified beneficiary) must be provided the same election / enrollment rights as an active employee which would permit election of employee + spouse coverage. Thanks.
Brian Gilmore Posted April 7, 2024 Posted April 7, 2024 Interesting situation. My reading is the spouse has the same right as any QB to add the former employee as dependent at OE. So I'd say the plan has to allow the spouse (as a QB) to enroll the former employee in the dental plan at OE. It will be a rare situation where the former employee is a non-QB COBRA dependent. Treas. Reg. Sec. 54.4980B-5: Q-. 4. Can a qualified beneficiary who elects COBRA continuation coverage ever change from the coverage received by that individual immediately before the qualifying event? A- 4. ... (c) If an employer or employee organization makes an open enrollment period available to similarly situated active employees with respect to whom a qualifying event has not occurred, the same open enrollment period rights must be made available to each qualified beneficiary receiving COBRA continuation coverage. An open enrollment period means a period during which an employee covered under a plan can choose to be covered under another group health plan or under another benefit package within the same plan, or to add or eliminate coverage of family members. (d) The rules of this Q&A-4 are illustrated by the following examples: ... Example (2). (i) The facts are the same as in Example 1, except that E's family members are not covered under E's group health plan when E terminates employment. (ii) Although the family members do not have to be given an opportunity to elect COBRA continuation coverage, E must be allowed to add them to E's COBRA continuation coverage during the open enrollment period. This is true even though the family members are not, and cannot become, qualified beneficiaries (see Q&A-1 of §54.4980B-3).
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