The Department of Labor (DOL) has updated participant deadlines extensions, one specifically – for COBRA participants – during the pandemic, or ‘outbreak period’.
What is the Outbreak Period?
The Outbreak Period is the window of time beginning on March 1, 2020, and ending 60 days after the end of the declared national emergency. The national emergency is still ongoing, and the end will vary by region.
COBRA Time frames
The Consolidated Omnibus Budget Reconciliation Act (COBRA), prescribes time periods for electing coverage, paying premiums, and notifying the plan of certain qualifying events. The final rule extends the following COBRA timeframes:
- The 60-day period for qualified beneficiaries to elect COBRA coverage;
- The date for making COBRA premium payments (at least 45 days after the day of the initial COBRA election, and a grace period of at least 30 days for subsequent premium payments); and
- The date for individuals to notify the plan of a qualifying event or disability determination (in general, at least 60 days from the date of the event, loss of coverage or disability determination).
The following examples illustrate the extensions for qualified beneficiaries to elect and make premium payments for COBRA coverage. For purposes of these examples, the National Emergency ends on April 30, 2020, with the Outbreak Period ending June 29, 2020.
COBRA Election Example
Facts: Individual B works for Employer X and participates in X’s group health plan. Due to the National Emergency, Individual B, who has no other coverage, experiences a reduction of hours below the hours necessary to meet the group health plan’s eligibility requirements (a COBRA qualifying event). Individual B is provided a COBRA election notice on April 1, 2020. What is the deadline for Individual B to elect COBRA?
Conclusion: Disregarding the Outbreak Period, the last day of Individual B’s COBRA election period is 60 days after June 29, 2020, which is August 28, 2020.
COBRA Premium Payment Examples
Facts: On March 1, 2020, Individual C was receiving COBRA continuation coverage. More than 45 days had passed since she elected it. Monthly premium payments are due by the first of the month. The plan does not permit longer than the statutory 30-day grace period for making premium payments. Individual C made a timely February payment, but did not make the March payment or any subsequent payments during the Outbreak Period.
Additional Facts: As of July 1, Individual C has made no premium payments for March, April, May or June. Does Individual C lose COBRA coverage, and if so for which months?
Conclusion: Because the Outbreak Period is disregarded, premium payments for all four months are due 30 days after June 29, 2020. Thus, as long as Individual C makes all of the premium payments by July 29, 2020, she is eligible to receive COBRA continuation coverage during March, April, May and June.
Additional Facts: By July 29, 2020, Individual C made a payment equal to only two months’ worth of premiums. For how long does Individual C have COBRA continuation coverage?
Conclusion: Individual C is entitled to COBRA continuation coverage for March and April, the two months for which timely premium payments were made. She is not entitled to coverage for any month after that.
This overview is not intended to be exhaustive nor shouldn’t discussion or opinions be constructed as legal advice. Readers should contact legal counsel for legal advice.