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What Is COBRA Continuation Coverage and How Does It Work?

Explains who has the right to continue group health coverage after a qualifying event and how long continuation lasts depending on the event. Covers the requirement that the coverage offered match what the person had before.

COBRA gives former employees and their covered dependents the right to continue group health plan coverage after certain qualifying events. Continuation runs 18 or 36 months depending on the event, and the coverage offered must match what they had the day before.

Who has the right to continue coverage

COBRA gives former employees and their covered dependents the right to continue coverage under a group health plan if the loss of coverage was due to certain events, known as qualifying events. The coverage offered must be the same coverage the individual enjoyed the day before the qualifying event, and it must be offered even if it is no longer of value to the individual.

Every qualified beneficiary (QB) who lost group health plan coverage as a result of the qualifying event must be offered the opportunity to elect COBRA. A QB is a covered employee, the spouse of a covered employee, or the dependent child of a covered employee who was covered by a group health plan immediately before the qualifying event.

Qualifying events and continuation periods

Qualifying eventAffectsPeriod of coveragePossible coverage extensions
Involuntary termination; Voluntary termination; Reduction of hoursEmployee; Covered spouse; Covered child(ren)18 monthsDisability extension; second qualifying event (see below)
Divorce or legal separation; Employee's Medicare entitlement; Death of covered employeeCovered spouse; Covered child(ren)36 monthsNot eligible for a coverage extension for any reason; this is the maximum continuation period under COBRA.
Loss of dependent statusCovered child(ren)36 monthsNot eligible for a coverage extension for any reason; this is the maximum continuation period under COBRA.

Extensions to the 18-month period

Disability extension

All qualified beneficiaries may qualify for an additional 11 months of coverage if one QB is determined to be disabled by the Social Security Administration and certain conditions are met.

Second qualifying event

When a covered spouse or child experiences a second qualifying event following a termination of employment or reduction of hours qualifying event, the original 18-month period is extended to 36 months from the original qualifying event date.

What else the law requires of employers

The law also mandated when and how an employer must inform qualified beneficiaries of their COBRA rights, restricted the amount an employer may charge individuals who want to continue coverage, and established administrative procedures every covered employer must follow when administering COBRA benefits.

For an in-depth explanation of COBRA, see Continuation of Health Coverage (COBRA) from the U.S. Department of Labor (dol.gov).

Frequently asked questions

What is COBRA continuation coverage?

COBRA gives former employees and their covered dependents the right to continue coverage under a group health plan when coverage is lost because of certain qualifying events. The coverage offered must be the same coverage the individual had the day before the qualifying event, and it must be offered even if it is no longer of value to that person.

How long does COBRA coverage last?

Involuntary termination, voluntary termination or a reduction of hours entitles the employee, covered spouse and covered children to 18 months of continuation coverage. Divorce or legal separation, the employee's Medicare entitlement, the death of the covered employee, or a child's loss of dependent status entitle covered spouses and children to 36 months.

Can COBRA coverage be extended beyond 18 months?

Yes, in two situations. All qualified beneficiaries may qualify for an additional 11 months if one of them is determined disabled by the Social Security Administration and certain conditions are met, and a second qualifying event experienced by a covered spouse or child after a termination or reduction-of-hours event extends the original 18-month period to 36 months from the original qualifying event date.

Who counts as a qualified beneficiary under COBRA?

A qualified beneficiary is the covered employee, the spouse of a covered employee, or the dependent child of the covered employee who was covered by the group health plan immediately before the qualifying event. Every qualified beneficiary who lost coverage as a result of the qualifying event must be offered the opportunity to elect COBRA.

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