Chances are you
are. If you work for a company that employs 20 or more employees, then your
company’s health plan falls under COBRA, which takes you most of the way
towards eligibility. There are three parts to qualifying for COBRA
coverage. (Note: you will notice references to ‘the plan’ throughout
this article. Recall that COBRA provides for continuation of benefits under the
same plan you had under your employer; as such, many of those plan rules will
still apply. At its simplest, COBRA allows you to keep your identical benefits
for a while longer, where you might normally not be able to do so.) The three parts to eligibility are:
1. Your
employer must offer group health coverage and employ 20 or more workers. This
makes the plan fall under COBRA law.
2. You have to be a Qualified
Beneficiary; this may seem odd, as mostly when the word ‘beneficiary’
is used one thinks of someone other than oneself. However, in this case, a
Qualified Beneficiary refers to the employee, the spouse of the employee and/or
the dependent children of the employee. In some cases, retirees and their
spouses and dependant children may be considered Qualified Beneficiaries as
well.
3. There has to be a Qualifying
Event, which is a circumstance that results in you losing your
coverage. There are different Qualifying Events depending on what kind of
Qualified Beneficiary you are, as outlined below.
Employee
Voluntary or involuntary termination of employment
for reasons other than "gross misconduct”
A
reduction in work hours that would result in cancellation of benefits
Spouse
If
the employee loses coverage for either reason above
If
the employee dies
If
there is a divorce or legal separation
If the
employee becomes eligible for Medicare
Dependent Child
Loss
of ‘dependant child’ status according to the plan (often when the child is over
19 and not a full-time student; although, even this rule varies from state to
state.)