DESCRIPTION OF TITLE III OF H.R. 598, THE 

“HEALTH INSURANCE ASSISTANCE FOR THE 

UNEMPLOYED ACT OF 2009” 

Scheduled for Markup 

By the 

HOUSE COMMITTEE ON WAYS AND MEANS 

on January 22, 2009 

Prepared by the Staff 

of the 

JOINT COMMITTEE ON TAXATION 

 

 

January 21, 2009 

JCX-6-09
i 

CONTENTS 

Page

INTRODUCTION .......................................................................................................................... 1 

A. Premium Assistance for COBRA Continuation Coverage .............................................. 2 

B. Extension of Minimum COBRA Continuation Coverage .............................................. 11 
1 

INTRODUCTION 

This document,1

 prepared by the staff of the Joint Committee on Taxation, provides a 

description of the revenue provisions of Title III of H.R. 598, the “Health Insurance Assistance 

for the Unemployed Act of 2009,” introduced by Mr. Rangel, Mr. Stark, and Mr. McDermott, 

and scheduled for markup by the Committee on Ways and Means of the House of 

Representatives on January 22, 2009. Title III of the bill provides for a subsidy for certain 

involuntarily terminated employees and their dependents with respect to continuation coverage 

that is required to be offered under group health plans pursuant to the Internal Revenue Code (the 

“Code”) and other law. Title III also permits a State to offer coverage under the State’s 

Medicaid program to certain workers terminated from employment and other specified 

individuals. 

 

 

                                                            1

 This document may be cited as follows: Joint Committee on Taxation, “Description of Title III 

of H.R.598, the Health Insurance Assistance for the Unemployed Act of 2009,” (JCX-6-09), January 21, 

2009. This document can also be found on our website at www.jct.gov. Unless otherwise noted, all 

section references are to the Internal Revenue Code of 1986, as amended (the “Code”). 
2 

A. Premium Assistance for COBRA Continuation Coverage 

Present Law

In general

The Code contains rules that require certain group health plans to offer certain 

individuals (“qualified beneficiaries”) the opportunity to continue to participate for a specified 

period of time in the group health plan (“continuation coverage”) after the occurrence of certain 

events that otherwise would have terminated such participation (“qualifying events”).2

 These 

continuation coverage rules are often referred to as “COBRA continuation coverage” or 

“COBRA,” which is a reference to the acronym for the law that added the continuation coverage 

rules to the Code.3

 The Code imposes an excise tax on a group health plan if it fails to comply with the 

COBRA continuation coverage rules with respect to a qualified beneficiary. The excise tax with 

respect to a qualified beneficiary generally is equal to $100 for each day in the noncompliance 

period with respect to the failure. A plan’s noncompliance period generally begins on the date 

the failure first occurs and ends when the failure is corrected. Special rules apply that limit the 

amount of the excise tax if the failure would not have been discovered despite the exercise of 

reasonable diligence or if the failure is due to reasonable cause and not willful neglect. 

In the case of a multiemployer plan, the excise tax is imposed on the group health plan. 

A multiemployer plan is a plan to which more than one employer is required to contribute, that is 

maintained pursuant to one or more collective bargaining agreements between one or more 

employee organizations and more than one employer, and that satisfies such other requirements 

as the Secretary of Labor may prescribe by regulation. In the case of a plan other than a 

multiemployer plan (a “single employer plan”), the excise tax is imposed on the employer. 

Plans subject to COBRA

A group health plan is defined as a plan of, or contributed to by, an employer (including a 

self-employed person) or employee organization to provide health care (directly or otherwise) to 

the employees, former employees, the employer, and others associated or formerly associated 

with the employer in a business relationship, or their families. A group health plan includes a 

self-insured plan. The term group health plan does not, however, include a plan under which 

substantially all of the coverage is for qualified long-term care services. 

The following types of group health plans are not subject to the Code’s COBRA rules: 

(1) a plan established and maintained for its employees by a church or by a convention or 

                                                            2

 Sec. 4980B. 

3

 The COBRA rules were added to the Code by the Consolidated Omnibus Budget 

Reconciliation Act of 1985, Pub. L. No. 99-272. The rules were originally added as Code sections 162(i) 

and (k). The rules were later restated as Code section 4980B, pursuant to the Technical and 

Miscellaneous Revenue Act of 1988, Pub. L. No. 100-647. 
3 

association of churches which is exempt from tax under section 501 (a “church plan”); (2) a plan 

established and maintained for its employees by the Federal government, the government of any 

State or political subdivision thereof, or by any instrumentality of the foregoing (a 

“governmental plan”);4

 and (3) a plan maintained by an employer that normally employed fewer 

than 20 employees on a typical business day during the preceding calendar year5

 (a “small 

employer plan”). 

Qualifying events and qualified beneficiaries

A qualifying event that gives rise to COBRA continuation coverage includes, with 

respect to any covered employee, the following events which would result in a loss of coverage 

of a qualified beneficiary under a group health plan (but for COBRA continuation coverage): (1) 

death of the covered employee; (2) the termination (other than by reason of such employee’s 

gross misconduct), or a reduction in hours, of the covered employee’s employment; (3) divorce 

or legal separation of the covered employee; (4) the covered employee becoming entitled to 

Medicare benefits under title XVIII of the Social Security Act; (5) a dependent child ceasing to 

be a dependent child under the generally applicable requirements of the plan; and (6) a 

proceeding in a case under the U.S. Bankruptcy Code commencing on or after July 1, 1986, with 

respect to the employer from whose employment the covered employee retired at any time. 

A “covered employee” is an individual who is (or was) provided coverage under the 

group health plan on account of the performance of services by the individual for one or more 

persons maintaining the plan and includes a self-employed individual. A “qualified beneficiary” 

means, with respect to a covered employee, any individual who on the day before the qualifying 

event for the employee is a beneficiary under the group health plan as the spouse or dependent 

child of the employee. The term qualified beneficiary also includes the covered employee in the 

case of a qualifying event that is a termination of employment or reduction in hours. 

Continuation coverage requirements

Continuation coverage that must be offered to qualified beneficiaries pursuant to COBRA 

must consist of coverage which, as of the time coverage is being provided, is identical to the 

coverage provided under the plan to similarly situated non-COBRA beneficiaries under the plan 

with respect to whom a qualifying event has not occurred. If coverage under a plan is modified 

for any group of similarly situated non-COBRA beneficiaries, the coverage must also be 

modified in the same manner for qualified beneficiaries. Similarly situated non-COBRA 

beneficiaries means the group of covered employees, spouses of covered employees, or 

dependent children of covered employees who (i) are receiving coverage under the group health 

plan for a reason other than pursuant to COBRA, and (ii) are the most similarly situated to the 

situation of the qualified beneficiary immediately before the qualifying event, based on all of the 

facts and circumstances. 

                                                            4

 A governmental plan also includes certain plans established by an Indian tribal government. 

5

 If the plan is a multiemployer plan, then each of the employers contributing to the plan for a 

calendar year must normally employ fewer than 20 employees during the preceding calendar year. 
4 

The maximum required period of continuation coverage for a qualified beneficiary (i.e., 

the minimum period for which continuation coverage must be offered) depends upon a number 

of factors, including the specific qualifying event that gives rise to a qualified beneficiary’s right 

to elect continuation coverage. In the case of a qualifying event that is the termination, or 

reduction of hours, of a covered employee’s employment, the minimum period of coverage that 

must be offered to the qualified beneficiary is coverage for the period beginning with the loss of 

coverage on account of the qualifying event and ending on the date that is 18 months6

 after the 

date of the qualifying event. If coverage under a plan is lost on account of a qualifying event but 

the loss of coverage actually occurs at a later date, the minimum coverage period may be 

extended by the plan so that it is measured from the date when coverage is actually lost. 

The minimum coverage period for a qualified beneficiary generally ends upon the earliest 

to occur of the following events: (1) the date on which the employer ceases to provide any group 

health plan to any employee, (2) the date on which coverage ceases under the plan by reason of a 

failure to make timely payment of any premium required with respect to the qualified 

beneficiary, and (3) the date on which the qualified beneficiary first becomes (after the date of 

election of continuation coverage) either (i) covered under any other group health plan (as an 

employee or otherwise) which does not include any exclusion or limitation with respect to any 

preexisting condition of such beneficiary or (ii) entitled to Medicare benefits under title XVIII of 

the Social Security Act. Mere eligibility for another group health plan or Medicare benefits is 

not sufficient to terminate the minimum coverage period. Instead, the qualified beneficiary must 

be actually covered by the other group health plan or enrolled in Medicare. Coverage under 

another group health plan or enrollment in Medicare does not terminate the minimum coverage 

period if such other coverage or Medicare enrollment begins on or before the date that 

continuation coverage is elected. 

Election of continuation coverage

The COBRA rules specify a minimum election period under which a qualified 

beneficiary is entitled to elect continuation coverage. The election period begins not later than 

the date on which coverage under the plan terminates on account of the qualifying event, and 

ends not earlier than the later of 60 days or 60 days after notice is given to the qualified 

beneficiary of the qualifying event and the beneficiary’s election rights. 

Notice requirements

A group health plan is required to give a general notice of COBRA continuation coverage 

rights to employees and their spouses at the time of enrollment in the group health plan. 

An employer is required to give notice to the plan administrator of certain qualifying 

events (including a loss of coverage on account of a termination of employment or reduction in 

                                                            6

 In the case of a qualified beneficiary who is determined, under Title II or XVI of the Social 

Security Act, to have been disabled during the first 60 days of continuation coverage, the 18 month 

minimum coverage period is extended to 29 months with respect to all qualified beneficiaries if notice is 

given before the end of the initial 18 month continuation coverage period. 
5 

hours) generally within 30 days of the qualifying event. A covered employee or qualified 

beneficiary is required to give notice to the plan administrator of certain qualifying events within 

60 days after the event. The qualifying events giving rise to an employee or beneficiary 

notification requirement are the divorce or legal separation of the covered employee or a 

dependent child ceasing to be a dependent child under the terms of the plan. Upon receiving 

notice of a qualifying event from the employer, covered employee, or qualified beneficiary, the 

plan administrator is then required to give notice of COBRA continuation coverage rights within 

14 days to all qualified beneficiaries with respect to the event. 

Premiums

A plan may require payment of a premium for any period of continuation coverage. The 

amount of such premium generally may not exceed 102 percent7 of the “applicable premium” for 

such period and the premium must be payable, at the election of the payor, in monthly 

installments. 

The applicable premium for any period of continuation coverage means the cost to the 

plan for such period of coverage for similarly situated non-COBRA beneficiaries with respect to 

whom a qualifying event has not occurred, and is determined without regard to whether the cost 

is paid by the employer or employee. The determination of any applicable premium is made for 

a period of 12 months (the “determination period”) and is required to be made before the 

beginning of such 12 month period. 

In the case of a self-insured plan, the applicable premium for any period of continuation 

coverage of qualified beneficiaries is equal to a reasonable estimate of the cost of providing 

coverage during such period for similarly situated non-COBRA beneficiaries which is 

determined on an actuarial basis and takes into account such factors as the Secretary of Treasury 

prescribes in regulations. A self-insured plan may elect to determine the applicable premium on 

the basis of an adjusted cost to the plan for similarly situated non-COBRA beneficiaries during 

the preceding determination period. 

A plan may not require payment of any premium before the day which is 45 days after 

the date on which the qualified beneficiary made the initial election for continuation coverage. A 

plan is required to treat any required premium payment as timely if it is made within 30 days 

after the date the premium is due or within such longer period as applies to, or under, the plan. 

Other continuation coverage rules

Continuation coverage rules which are parallel to the Code’s continuation coverage rules 

apply to group health plans under the Employee Retirement Income Security Act of 1974 

(ERISA).8

 ERISA generally permits the Secretary of Labor and plan participants to bring a civil 

                                                            7

 In the case of a qualified beneficiary whose minimum coverage period is extended to 29 

months on account of a disability determination, the premium for the period of the disability extension 

may not exceed 150 percent of the applicable premium for the period. 

8

 Secs. 601 to 608 of ERISA. 
6 

action to obtain appropriate equitable relief to enforce the continuation coverage rules of ERISA, 

and in the case of a plan administrator who fails to give timely notice to a participant or 

beneficiary with respect to COBRA continuation coverage, a court may hold the plan 

administrator liable to the participant or beneficiary in the amount of up to $110 a day from the 

date of such failure. 

Although the Federal government and State and local governments are not subject to the 

Code and ERISA’s continuation coverage rules, other laws impose similar continuation coverage 

requirements with respect to plans maintained by such governmental employers.9

 In addition, 

many States have enacted laws or promulgated regulations that provide continuation coverage 

rights that are similar to COBRA continuation coverage rights in the case of a loss of group 

health coverage. Such State laws, for example, may apply in the case of a loss of coverage under 

a group health plan maintained by a small employer. 

Description of Proposal

Reduced COBRA premium

The provision provides that, for a period not exceeding 12 months, an assistance eligible 

individual is treated as having paid any premium required for COBRA continuation coverage 

under a group health plan if the individual pays 35 percent of the premium.10 Thus, if the 

assistance eligible individual pays 35 percent of the premium, the group health plan must treat 

the individual as having paid the full premium required for COBRA continuation coverage, and 

the individual is entitled to a subsidy for 65 percent of the premium. An assistance eligible 

individual is any qualified beneficiary who elects COBRA continuation coverage and satisfies 

two additional requirements. First, the qualifying event with respect to the covered employee for 

that qualified beneficiary must be a loss of group health plan coverage on account of an 

involuntary termination of the covered employee’s employment. However, a termination of 

employment for gross misconduct does not qualify (since such a termination under present law 

does not qualify for COBRA continuation coverage). Second, the qualifying event must occur 

during the period beginning September 1, 2008 and ending with December 31, 2009 and the 

qualified beneficiary must be eligible for COBRA continuation coverage during that period and 

elect such coverage. 

                                                            9

 Continuation coverage rights similar to COBRA continuation coverage rights are provided to 

individuals covered by health plans maintained by the Federal government. 5 U.S.C. sec. 8905a. Group 

health plans maintained by a State that receives funds under Chapter 6A of Title 42 of the United States 

Code (the Public Health Service Act) are required to provide continuation coverage rights similar to 

COBRA continuation coverage rights for individuals covered by plans maintained by such State (and 

plans maintained by political subdivisions of such State and agencies and instrumentalities of such State 

or political subdivision of such State). 42 U.S.C. sec. 300bb-1. 

10 For this purpose, payment by an assistance eligible individual includes payment by another 

individual paying on behalf of the individual, such as a parent or guardian, or an entity paying on behalf 

of the individual, such as a State agency or charity. 
7 

An assistance eligible individual can be any qualified beneficiary associated with the 

relevant covered employee (e.g., a dependent of an employee who is covered immediately prior 

to a qualifying event), and such qualified beneficiary can independently elect COBRA (as 

provided under present law COBRA rules) and independently receive a subsidy. Thus, the 

subsidy for an assistance eligible individual continues after an intervening death of the covered 

employee. 

Under the provision, any subsidy provided is excludible from the gross income of the 

covered employee and any assistance eligible individuals. However, for purposes of determining 

the gross income of the employer and any welfare benefit plan of which the group health plan is 

a part, the amount of the premium reduction is intended to be treated as an employee 

contribution to the group health plan. Finally, under the provision, notwithstanding any other 

provision of law, the subsidy is not permitted to be considered as income or resources in 

determining eligibility for, or the amount of assistance or benefits under, any public benefit 

provided under Federal or State law (including the law of any political subdivision). 

Eligible COBRA continuation coverage

Under the provision, continuation coverage that qualifies for the subsidy is not limited to 

coverage required to be offered under the Code’s COBRA rules but also includes continuation 

coverage required under State law that requires continuation coverage comparable to the 

continuation coverage required under the Code’s COBRA rules for group health plans not 

subject to those rules (e.g., a small employer plan) and includes continuation coverage 

requirements that apply to health plans maintained by the Federal government or a State 

government. Comparable continuation coverage under State law does not include every State 

law right to continue health coverage, such as a right to continue coverage with no rules that 

limit the maximum premium that can be charged with respect to such coverage. To be 

comparable, the right generally must be to continue substantially similar coverage as was 

provided under the group health plan (or substantially similar coverage as is provided to 

similarly situated beneficiaries) at a monthly cost that is based on a specified percentage of the 

group health plan’s cost of providing such coverage. 

The cost of coverage under any group health plan that is subject to the Code’s COBRA 

rules (or comparable State requirements or continuation coverage requirement under health plans 

maintained by the Federal government or any State government) is eligible for the subsidy, 

except contributions to a health flexible spending account. 

Termination of eligibility for reduced premiums

The assistance eligible individual’s eligibility for the subsidy terminates with the first 

month beginning on or after the earlier of (1) the date which is 12 months after the first day of 

the first month for which the subsidy applies, (2) the end of the maximum required period of 

continuation coverage for the qualified beneficiary under the Code’s COBRA rules or the 

relevant State or Federal law (or regulation), or (3) the date that the assistance eligible individual 

becomes eligible for Medicare benefits under title XVIII of the Social Security Act or health 

coverage under another group health plan (including, for example, a group health plan 

maintained by the new employer of the individual or a plan maintained by the employer of the 
8 

individual’s spouse). However, eligibility for coverage under another group health plan does 

not terminate eligibility for the subsidy if the other group health plan provides only dental, 

vision, counseling, or referral services (or a combination of the foregoing), is a health flexible 

spending account or health reimbursement arrangement, or is coverage for treatment that is 

furnished in an on-site medical facility maintained by the employer and that consists primarily of 

first-aid services, prevention and wellness care, or similar care (or a combination of such care). 

If a qualified beneficiary paying a reduced premium for COBRA continuation coverage 

under this provision becomes eligible for coverage under another group health plan or Medicare, 

the provision requires the qualified beneficiary to notify, in writing, the group health plan 

providing the COBRA continuation coverage with the reduced premium of such eligibility under 

the other plan or Medicare. The notification by the assistance eligible individual must be 

provided to the group health plan in the time and manner as is specified by the Secretary of 

Labor. If an assistance eligible individual fails to provide this notification at the required time 

and in the required manner, and as a result the individual’s COBRA continuation coverage 

continues to be subsidized after the termination of the individual’s eligibility for such subsidy, a 

penalty is imposed on the individual equal to 110 percent of the subsidy provided after 

termination of eligibility. 

This penalty only applies if the subsidy in the form of the premium reduction is actually 

provided to a qualified beneficiary for a month that the beneficiary is not eligible for the 

reduction. Thus, for example, if a qualified beneficiary becomes eligible for coverage under 

another group health plan and stops paying the reduced COBRA continuation premium, the 

penalty generally will not apply. As discussed below, under the provision, the group health plan 

is reimbursed for the subsidy for a month (65 percent of the amount of the premium for the 

month) only after receipt of the qualified beneficiary’s portion (35 percent of the premium 

amount). Thus, the penalty generally will only arise when the qualified beneficiary continues to 

pay the reduced premium and does not notify the group health plan providing COBRA 

continuation coverage of the beneficiary’s eligibility under another group health plan or 

Medicare. 

Special COBRA election opportunity

The provision provides a special 60 day election period for a qualified beneficiary who is 

eligible for a reduced premium and who has not elected COBRA continuation coverage as of the 

date of enactment. The 60 day election period begins on the date that notice is provided to the 

qualified beneficiary of the special election period. However, this special election period does 

not extend the period of COBRA continuation coverage beyond the original maximum required 

period (generally 18 months after the qualifying event) and any COBRA continuation coverage 

elected pursuant to this special election period begins on the date of enactment and does not 

include any period prior to that date. Thus, for example, if a covered employee involuntarily 

terminated employment on September 10, 2008, but did not elect COBRA continuation coverage 

and was not eligible for coverage under another group health plan, the employee would have 60 

days after date of notification of this new election right to elect the coverage and receive the 

subsidy. If the employee made the election, the coverage would begin with the date of enactment 

and would not include any period prior to that date. However, the coverage would not be 
9 

required to last for 18 months. Instead the maximum required COBRA continuation coverage 

period would end not later than 18 months after September 10, 2008. 

The special enrollment provision applies to a group health plan that is subject to the 

COBRA continuation coverage requirements of the Code, ERISA, title 5 of the United States 

Code (relating to plans maintained by the Federal government), or the Public Health Service Act 

(“PHSA”). 

With respect to an assistance eligible individual who elects coverage pursuant to the 

special election period, the period beginning on the date of the qualifying event and ending with 

the day before the date of enactment is disregarded for purposes of the rules that limit the group 

health plan from imposing pre-existing condition limitations with respect to the individual’s 

coverage.

11

Reimbursement of group health plans 

The provision provides that the entity to which premiums are payable (determined under 

the applicable COBRA continuation coverage requirement)12 shall be reimbursed by the amount 

of the premium for COBRA continuation coverage that is not paid by an assistance eligible 

individual on account of the premium reduction. An entity is not eligible for subsidy 

reimbursement, however, until the entity has received the reduced premium payment from the 

assistance eligible individual. To the extent that such entity has liability for income tax 

withholding from wages13 or FICA taxes14 with respect to its employees, the entity is reimbursed 

by treating the amount that is reimbursable to the entity as a credit against its liability for these 

payroll taxes.15 To the extent that such amount exceeds the amount of the entity’s liability for 

                                                            11 Section 9801 provides that a group health plan may impose a pre-existing condition exclusion 

for no more than 12 months after a participant or beneficiary’s enrollment date. Such 12-month period 

must be reduced by the aggregate period of creditable coverage (which includes periods of coverage 

under another group health plan). A period of creditable coverage can be disregarded if, after the 

coverage period and before the enrollment date, there was a 63-day period during which the individual 

was not covered under any creditable coverage. Similar rules are provided under ERISA and PHSA. 

12 Applicable continuation coverage that qualifies for the subsidy and thus for reimbursement is 

not limited to coverage required to be offered under the Code’s COBRA rules but also includes 

continuation coverage required under State law that requires continuation coverage comparable to the 

continuation coverage required under the Code’s COBRA rules for group health plans not subject to those 

rules (e.g., a small employer plan) and includes continuation coverage requirements that apply to health 

plans maintained by the Federal government or a State government. 

13 Sec. 3401. 

14 Sec. 3102 (relating to FICA taxes applicable to employees) and sec. 3111 (relating to FICA 

taxes applicable to employers). 

15 In determining any amount transferred or appropriated to any fund under the Social Security 

Act, amounts credited against an employer’s payroll tax obligations pursuant to the provision shall not be 

taken into account. 
10 

these payroll taxes, the Secretary shall reimburse the entity for the excess directly. The provision 

requires any entity entitled to such reimbursement to submit such reports as the Secretary of 

Treasury may require, including an attestation of the involuntary termination of employment of 

each covered employee on the basis of whose termination entitlement to reimbursement of 

premiums is claimed, and a report of the amount of payroll taxes offset for a reporting period and 

the estimated offsets of such taxes for the next reporting period. This report is required to be 

provided at the same time as the deposits of the payroll taxes would have been required, absent 

the offset, or such times as the Secretary specifies. 

Notice requirements

The notice of COBRA continuation coverage that a plan administrator is required to 

provide to qualified beneficiaries with respect to a qualifying event under present law must 

contain, under the provision, additional information including, for example, information about 

the qualified beneficiary’s right to the premium reduction (and subsidy) and the conditions on the 

subsidy, and a description of the obligation of the qualified beneficiary to notify the group health 

plan of eligibility under another group health plan or eligibility for Medicare benefits under title 

XVIII of the Social Security Act, and the penalty for failure to provide this notification. The 

provision also requires a new notice to be given to qualified beneficiaries entitled to a special 

election period after enactment. In the case of group health plans that are not subject to the 

COBRA continuation coverage requirements of the Code, ERISA, title 5 of the United States 

Code (relating to plans maintained by the Federal government), or PHSA, the provision requires 

that notice be given to the relevant employees and beneficiaries as well, as specified by the 

Secretary of Labor. Within 30 days after enactment, the Secretary of Labor is directed to provide 

model language for the additional notification required under the provision. The provision also 

provides an expedited 10-day review process by the Department of Labor, under which an 

individual may request review of a denial of treatment as an assistance eligible individual by a 

group health plan. 

Regulatory authority

The provision provides authority to the Secretary of the Treasury to issue regulations or 

other guidance as may be necessary or appropriate to carry out the provision, including any 

reporting requirements or the establishment of other methods for verifying the correct amounts 

of payments and credits under the provision. For example, the Secretary of the Treasury might 

require verification on the return of an assistance eligible individual who is the covered 

employee that the individual’s termination of employment was involuntary. The provision also 

provides authority to Treasury to promulgate rules, procedures, regulations, and other guidance 

as is necessary and appropriate to prevent fraud and abuse in the subsidy program, including the 

employment tax offset mechanism. 

Effective Date

The provision is effective for premiums for months of coverage beginning on or after the 

date of enactment. 
11 

B. Extension of Minimum COBRA Continuation Coverage 

Present Law

In general

A covered employee’s termination of employment (other than for gross misconduct), 

whether voluntary or involuntary, is a COBRA qualifying event.16 A covered employee’s 

reduction in hours of employment, whether voluntary or involuntary, is also a COBRA 

qualifying event if the reduction results in a loss of employer sponsored group health plan 

coverage.17 

The minimum length of coverage continuation that must be offered to a qualified 

beneficiary depends upon a number of factors, including the specific qualifying event that gives 

rise to a qualified beneficiary’s right to elect coverage continuation. In the case of a qualifying 

event that is the termination, or reduction of hours, of a covered employee’s employment, the 

minimum period of coverage that must be offered to each qualified beneficiary generally must 

extend until 18 months after the date of the qualifying event.18 Under certain circumstances, 

however, the coverage continuation period can be extended up to a maximum total of 36 months. 

For example, if a second qualifying event occurs within the initial 18 month continuation period 

the initial period will be extended up to an additional 18 months (for a total of 36 months) for 

qualified beneficiaries other than the covered employee. Similarly, if a qualified beneficiary is 

determined to be disabled for purposes of Social Security during the first 60 days of the initial 18 

month continuation coverage period, the initial 18 month period may be extended up to an 

additional 11 months (for a total of 29 months) for the disabled beneficiary and all of his or her 

covered family members. If a second qualifying event then occurs during the additional 11 

month coverage period, the continuation period may be extended for another seven months, for a 

total of 36 months of continuation coverage. 

Description of Proposal

The provision amends section 4980B(f)(2)(B) to provide extended COBRA coverage 

periods for covered employees who qualify for COBRA continuation coverage due to 

termination of employment or reduction in hours and who (a) are age 55 or older, or (b) have 10 

or more years of service with the employer, at the time of the qualifying event. Such individuals 

would be permitted to continue their COBRA coverage until the earlier of enrollment for 

Medicare benefits under title XVIII of the Social Security Act or termination of all health plans 

sponsored by the employer offering the COBRA coverage. The extended coverage period would 

apply to all qualified beneficiaries of the covered employee. 

                                                            16 Sec. 4980B(f)(3)(B); Treas. Reg. 54.4980B-4. 

17 Sec. 4980(f)(3)(B). 

18 Sec. 4980B((f)(2)(B)(i)(I). If coverage under a plan is lost on account of a qualifying event 

but the loss of coverage actually occurs at a later date, the minimum coverage period may be extended by 

the plan so that it is measured from the date when coverage is actually lost. 
12 

The provision makes parallel changes to ERISA and PHSA. 

Effective Date

The provision is effective for periods of coverage which would (without regard to any 

amendments made by the provision) end on or after the date of enactment.