From the Hotline: COBRA and Dependents

Question: Our employee’s dependent reached age 26, was removed from our group plan, and elected COBRA coverage. While on COBRA, the dependent had a child. Can the child be added to COBRA?

Answer: The Consolidated Omnibus Budget Reconciliation Act (COBRA) beneficiary is entitled to add a dependent to his or her COBRA coverage under HIPAA’s special enrollment provisions due to the birth of the child. Remember that qualified beneficiaries must be offered identical coverage to the available coverage to similarly situated beneficiaries who are not receiving COBRA coverage under the plan. Qualified beneficiaries must be allowed to make the same choices given to non-COBRA beneficiaries under the plan, such as during periods of open enrollment by the plan and special enrollment. Special enrollment allows individuals who previously declined health coverage to enroll for coverage.

Special enrollment rights arise regardless of a plan’s open enrollment period. There are two types of special enrollment — upon loss of eligibility for other coverage and upon certain life events. Life events include marriage, birth, adoption, or placement for adoption. Individuals must request enrollment within 30 days of the loss of coverage or life event triggering the special enrollment.