A young adult who no longer meets "dependent status" rules can continue health insurance as a COBRA participant.
Most Americans receive health insurance as a fringe benefit of employment or as the spouse or dependent of a family member enrolled in a group health plan. The Consolidated Omnibus Budget Reconciliation Act, or COBRA, allows you to temporarily continue health insurance at your own expense after a "qualifying event" -- a circumstance that causes you to lose group health plan eligibility. The qualifying event determines whether you can continue plan benefits as a COBRA participant as well as the length of time you can remain a COBRA beneficiary, according U.S. Department of Labor guidelines.
Employee Qualifying Events
Employers generally offer health insurance as part of an employee's compensation package. Upon retirement, resignation, layoff or termination you lose eligibility to participate in the group plan. These events qualify you to continue health benefits under the plan as a COBRA participant. Many employer-sponsored plans also require you to maintain a full-time work schedule to qualify for membership. If your employer reduces your work schedule and you lose eligibility for the group plan, you can elect to continue benefits as a COBRA participant.
Spouse/Dependent Qualifying Events
An employee's retirement, resignation or layoff also trigger COBRA eligibility for a spouse and children enrolled with the employee as dependents in a group health plan. Likewise, a reduction in a employee's work schedule that leads to his loss of eligibility qualifies his spouse and children for COBRA. Other events that could serve as COBRA qualifying events for a spouse and dependent children include the employee becoming eligible for Medicare benefits and the employee's death, DOL says.
Other Qualifying Events
The law allows children to continue receiving health insurance through your group health plan as a COBRA participants when they no longer fit the group health plan's rules for "dependent status." The law also allows a former spouse and minor children to retain health care benefits after a divorce or legal separation, DOL says.
Qualified Beneficiary Eligibility
In order to qualify for group coverage as COBRA beneficiaries, an employee, spouse, former spouse and dependents must have been covered by an employee group health plan the day before the qualifying event occurs. However, any child born to or placed for adoption with an employee while she receives COBRA continuation coverage automatically becomes a qualified beneficiary, DOL says.
Qualified Beneficiary Coverage Length
The law requires group health plans to offer to extend coverage 18 months to employees, spouses and children after qualifying events that include termination of employment or a reduction in the employee's work hours. However, you may request an additional 18 months if someone in your family becomes disabled or a second qualifying event occurs. For qualifying events that include employee enrollment in Medicare, divorce or legal separation, death of the covered employee and loss of dependent child status, the employee's spouse and children can continue plan benefits as COBRA participants for 36 months, DOL says.
