Document ID: ./input/supremecourt_opinions/opinions/boundvolumes/524bv.pdf
Page Number: 126

524us1$75M 02-18-99 19:35:22 PAGES OPINPGT

Cite as: 524 U. S. 74 (1998)

81

Opinion of the Court

The “applicable premium” is usually the cost to the plan of
providing continuation coverage, regardless of who usually
pays for the insurance beneﬁt.
§ 1164. Beneﬁts may cease
if the qualiﬁed beneﬁciary fails to pay the premiums,
§ 1162(2)(C), and an employer may terminate it for certain
other reasons, such as discontinuance of the group health
plan entirely, § 1162(2)(B). COBRA coverage may also
cease on

“[t]he date on which the qualiﬁed beneﬁciary ﬁrst be-
comes, after the date of the election—

“(i) covered under any other group health plan (as
an employee or otherwise), which does not contain any
exclusion or limitation with respect to any preexisting
condition of such beneﬁciary, or

“(ii) entitled to beneﬁts under title XVIII of the
§ 1162(2)(D).7

Social Security Act.”

7 When originally enacted, § 1162(2)(D)(i) provided that coverage could
cease when a qualiﬁed beneﬁciary “ﬁrst becomes, after the date of the
election . . . a covered employee under any other group health plan,” and
a separate provision, § 1162(E), provided that in the case of an individual
who was a qualiﬁed beneﬁciary as the result of being a spouse of a covered
employee, coverage could cease on “the date on which the beneﬁciary re-
marries and becomes covered under a group health plan.” COBRA, Pub.
L. 99–272, 100 Stat. 228. Congress later struck § 1162(E) and amended
subsection (i) to provide that coverage could cease when a qualiﬁed bene-
ﬁciary “ﬁrst becomes, after the date of the election . . . covered under any
other group health plan (as an employee or otherwise).” Tax Reform Act
of 1986, Pub. L. 99–514, 100 Stat. 2938–2939. Congress again amended
subsection (i) in 1989, when it added the qualiﬁcation, “which does not
contain any exclusion or limitation with respect to any preexisting condi-
tion of such beneﬁciary.” Omnibus Budget Reconciliation Act of 1989,
Pub. L. 101–239, 103 Stat. 2297, 2432. The Health Insurance Portability
and Accountability Act of 1996, Pub. L. 104–191, 110 Stat. 2087–2088,
amended § 1162(2)(D)(i) yet again by inserting before “, or”: “(other than
such an exclusion or limitation which does not apply to (or is satisﬁed by)
such beneﬁciary by reason of chapter 100 of the Internal Revenue Code of
1986, part 7 of subtitle B of title I of the Employee Retirement Income
Security Act of 1974, or title XXVII of this Act).” The 1996 amendment
was not in effect at the time this case arose.