erage shall be treated as COBRA continu-
ation coverage for purposes of the applica-
ble COBRA continuation coverage provi-
sion. 
(ii) REQUIREMENTS.—Any assistance 
eligible individual may elect to enroll in 
different coverage as described in clause (i) 
only if— 
(I) the employer involved has 
made a determination that such em-
ployer will permit such assistance eli-
gible individual to enroll in different 
coverage as provided under this sub-
paragraph; 
(II) the premium for such dif-
ferent coverage does not exceed the 
premium for coverage in which such 
individual was enrolled at the time 
such qualifying event occurred; 
(III) the different coverage in 
which the individual elects to enroll is 
coverage that is also offered to simi-
larly situated active employees of the 
employer at the time at which such 
election is made; and
(IV) the different coverage in 
which the individual elects to enroll is 
not— 
(aa) coverage that provides 
only excepted benefits as defined 
in section 9832(c) of the Internal 
Revenue Code of 1986, section 
733(c) of the Employee Retire-
ment Income Security Act of 
1974, and section 2791(c) of the 
Public Health Service Act; 
(bb) a qualified small em-
ployer health reimbursement ar-
rangement (as defined in section 
9831(d)(2) of the Internal Rev-
enue Code of 1986); or 
(cc) a flexible spending ar-
rangement (as defined in section 
106(c)(2) of the Internal Rev-
enue Code of 1986). 
(2) LIMITATION OF PERIOD OF PREMIUM AS-
SISTANCE.— 
(A) ELIGIBILITY
FOR
ADDITIONAL
COV-
ERAGE.—Paragraph (1)(A) shall not apply with 
respect to any assistance eligible individual de-
scribed in paragraph (3) for months of coverage 
beginning on or after the earlier of— 
(i) the first date that such individual 
is eligible for coverage under any other 
group health plan (other than coverage 
consisting of only excepted benefits (as de-
fined in section 9832(c) of the Internal 
Revenue Code of 1986, section 733(c) of 
the Employee Retirement Income Security 
Act of 1974, and section 2791(c) of the 
Public Health Service Act), coverage under 
a flexible spending arrangement (as de-
fined in section 106(c)(2) of the Internal 
Revenue Code of 1986), coverage under a 
qualified small employer health reimburse-
ment arrangement (as defined in section 
9831(d)(2) of the Internal Revenue Code 
of 1986)), or eligible for benefits under the 
Medicare program under title XVIII of the 
Social Security Act; or 
(ii) the earlier of— 
(I) the date following the expira-
tion of the maximum period of con-
tinuation coverage required under the
100 
applicable COBRA continuation cov-
erage provision; or 
(II) the date following the expira-
tion of the period of continuation cov-
erage 
allowed 
under 
paragraph 
(4)(B)(ii). 
(B) NOTIFICATION
REQUIREMENT.—Any 
assistance eligible individual shall notify the 
group health plan with respect to which para-
graph (1)(A) applies if such paragraph ceases 
to apply by reason of clause (i) of subparagraph 
(A). Such notice shall be provided to the group 
health plan in such time and manner as may be 
specified by the Secretary of Labor. 
(3) ASSISTANCE
ELIGIBLE
INDIVIDUAL.—For 
purposes of this section, the term ‘‘assistance eligible 
individual’’ means, with respect to a period of cov-
erage during the period beginning on the first day 
of the first month beginning after the date of the en-
actment of this Act, and ending on September 30, 
2021, any individual that is a qualified beneficiary 
who— 
(A) is eligible for COBRA continuation 
coverage by reason of a qualifying event speci-
fied in section 603(2) of the Employee Retire-
101 
ment Income Security Act of 1974, section 
4980B(f)(3)(B) of the Internal Revenue Code 
of 1986, or section 2203(2) of the Public 
Health Service Act, except for the voluntary 
termination of such individual’s employment by 
such individual; and 
(B) elects such coverage. 
(4) EXTENSION OF ELECTION PERIOD AND EF-
FECT ON COVERAGE.— 
(A) IN GENERAL.—For purposes of apply-
ing section 605(a) of the Employee Retirement 
Income 
Security 
Act 
of 
1974, 
section 
4980B(f)(5)(A) of the Internal Revenue Code 
of 1986, and section 2205(a) of the Public 
Health Service Act, in the case of— 
(i) an individual who does not have an 
election of COBRA continuation coverage 
in effect on the first day of the first month 
beginning after the date of the enactment 
of this Act but who would be an assistance 
eligible individual described in paragraph 
(3) if such election were so in effect; or 
(ii) an individual who elected COBRA 
continuation coverage and discontinued 
from such coverage before the first day of
102 
the first month beginning after the date of 
the enactment of this Act, 
such individual may elect the COBRA continu-
ation coverage under the COBRA continuation 
coverage provisions containing such provisions 
during the period beginning on the first day of 
the first month beginning after the date of the 
enactment of this Act and ending 60 days after 
the date on which the notification required 
under paragraph (6)(C) is provided to such in-
dividual. 
(B) COMMENCEMENT OF COBRA CONTINU-
ATION COVERAGE.—Any COBRA continuation 
coverage elected by a qualified beneficiary dur-
ing an extended election period under subpara-
graph (A)— 
(i) shall commence (including for pur-
poses of applying the treatment of pre-
mium payments under paragraph (1)(A) 
and any cost-sharing requirements for 
items and services under a group health 
plan) with the first period of coverage be-
ginning on or after the first day of the 
first month beginning after the date of the 
enactment of this Act, and
103 
(ii) shall not extend beyond the period 
of COBRA continuation coverage that 
would have been required under the appli-
cable COBRA continuation coverage provi-
sion if the coverage had been elected as re-
quired under such provision. 
(5) NOTICES TO INDIVIDUALS.— 
(A) GENERAL NOTICE.— 
(i) IN GENERAL.—In the case of no-
tices provided under section 606(a)(4) of 
the Employee Retirement Income Security 
Act of 1974 (29 U.S.C. 1166(4)), section 
4980B(f)(6)(D) of the Internal Revenue 
Code of 1986, or section 2206(4) of the 
Public Health Service Act (42 U.S.C. 
300bb–6(4)), with respect to individuals 
who, during the period described in para-
graph (3), become entitled to elect COBRA 
continuation coverage, the requirements of 
such provisions shall not be treated as met 
unless such notices include an additional 
written notification to the recipient in clear 
and understandable language of—
104 
(I) the availability of premium 
assistance with respect to such cov-
erage under this subsection; and 
(II) the option to enroll in dif-
ferent coverage if the employer per-
mits assistance eligible individuals de-
scribed in paragraph (3) to elect en-
rollment in different coverage (as de-
scribed in paragraph (1)(B)). 
(ii) ALTERNATIVE
NOTICE.—In the 
case of COBRA continuation coverage to 
which the notice provision under such sec-
tions does not apply, the Secretary of 
Labor, in consultation with the Secretary 
of the Treasury and the Secretary of 
Health and Human Services, shall, in con-
sultation with administrators of the group 
health plans (or other entities) that provide 
or administer the COBRA continuation 
coverage involved, provide rules requiring 
the provision of such notice. 
(iii) FORM.—The requirement of the 
additional notification under this subpara-
graph may be met by amendment of exist-
ing notice forms or by inclusion of a sepa-
105 
rate document with the notice otherwise 
required. 
(B) SPECIFIC REQUIREMENTS.—Each ad-
ditional notification under subparagraph (A) 
shall include— 
(i) the forms necessary for estab-
lishing eligibility for premium assistance 
under this subsection; 
(ii) the name, address, and telephone 
number necessary to contact the plan ad-
ministrator and any other person main-
taining relevant information in connection 
with such premium assistance; 
(iii) a description of the extended elec-
tion period provided for in paragraph 
(4)(A); 
(iv) a description of the obligation of 
the qualified beneficiary under paragraph 
(2)(B) and the penalty provided under sec-
tion 6720C of the Internal Revenue Code 
of 1986 for failure to carry out the obliga-
tion; 
(v) a description, displayed in a 
prominent manner, of the qualified bene-
ficiary’s right to a reduced premium and
106 
any conditions on entitlement to the re-
duced premium; and 
(vi) a description of the option of the 
qualified beneficiary to enroll in different 
coverage if the employer permits such ben-
eficiary to elect to enroll in such different 
coverage under paragraph (1)(B). 
(C) NOTICE
IN
CONNECTION
WITH
EX-
TENDED ELECTION PERIODS.—In the case of 
any assistance eligible individual described in 
paragraph (3) (or any individual described in 
paragraph (4)(A)) who became entitled to elect 
COBRA continuation coverage before the first 
day of the first month beginning after the date 
of the enactment of this Act, the administrator 
of the applicable group health plan (or other 
entity) shall provide (within 60 days after such 
first day of such first month) for the additional 
notification required to be provided under sub-
paragraph (A) and failure to provide such no-
tice shall be treated as a failure to meet the no-
tice requirements under the applicable COBRA 
continuation provision. 
(D) MODEL NOTICES.—Not later than 30 
days after the date of enactment of this Act,
107 
with respect to any assistance eligible individual 
described in paragraph (3), the Secretary of 
Labor, in consultation with the Secretary of the 
Treasury and the Secretary of Health and 
Human Services, shall prescribe models for the 
additional notification required under this para-
graph. 
(6) NOTICE
OF
EXPIRATION
OF
PERIOD
OF 
PREMIUM ASSISTANCE.— 
(A) IN GENERAL.—With respect to any as-
sistance eligible individual, subject to subpara-
graph 
(B), 
the 
requirements 
of 
section 
606(a)(4) of the Employee Retirement Income 
Security Act of 1974 (29 U.S.C. 1166(4)), sec-
tion 4980B(f)(6)(D) of the Internal Revenue 
Code of 1986, or section 2206(4) of the Public 
Health Service Act (42 U.S.C. 300bb–6(4)), 
shall not be treated as met unless the plan ad-
ministrator of the individual, during the period 
specified under subparagraph (C), provides to 
such individual a written notice in clear and un-
derstandable language— 
(i) that the premium assistance for 
such individual will expire soon and the