How long am I entitled to COBRA benefits?
This is determined by first establishing whether you are covered under a fully insured or a self-funded/self-insured plan. Recall that self-funded/self-insured private employer group health plans are required only to follow the federal law, while fully insured private employer group health plans and self-funded/self-insured government plans in Minnesota are required to follow both the federal COBRA law as well as the generally longer requirements for continuation coverage that Minnesota state law requires.
Under federal COBRA requirements, unless it is terminated for one of several reasons, coverage begins from the date of the qualifying event and it must continue for:
• 18 months (if the qualifying event was an employee’s termination of employment or a reduction in hours) for any qualified beneficiary
• 29 months (if the qualifying event was an employee’s termination of employment or a reduction in hours) and any qualified beneficiary is determined by the Social Security Administration to have been disabled during the first 60 days
of the continuation coverage for any qualified beneficiary
Example: You become disabled as determined by the Social Security Administration during the first 60 days of your COBRA coverage, you and your family members are entitled to COBRA continuation coverage for 29 months, rather than
• 36 months (if the qualifying event was an employee’s death, divorce, legal separation, or entitlement to Medicare benefits) for a spouse or dependent child,
• 36 months (if the qualifying event was the dependent child’s ceasing to meet the plan’s dependency requirements) for a dependent child,
Under Minnesota state law for fully insured private employer group health plans or self-funded/self-insured government plans the following extensions apply:
For the former employee: If the employee becomes totally disabled while employed, he or she can continue their coverage indefinitely (vs. 29 months under federal law).
For dependent children: If the covered employee dies, becomes disabled or divorced, dependent children may continue their coverage until they become covered under another group plan or no longer qualify as dependents.
For former or surviving spouses: If the COBRA qualifying event is the employee spouse’s death or the divorce or legal separation from the former employee spouse, a surviving spouse or former spouse can continue coverage until he or she becomes covered under another group plan or until he or she becomes enrolled in Medicare. (vs. the 36 month limit under federal law).