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I'm working with a T65 man who wants to enroll in a med supp or MA. He has employer coverage, but it is very expensive and not very good; so much so that he wanted to put his younger wife on COBRA until she got an individual plan, which she'd easily qualify for. I told him that his wife would be entitled to 36 months of COBRA due to his Medicare eligibility. Today he sent me the following email from the benefits admin at the private school where he teaches:
Here is what I have concluded. I had this information confirmed with benefits administrator's COBRA department.
Your wife is eligible for 18 months of standard COBRA coverage, plus an additional 6 months of state continuation coverage. The reason she would not be eligible for 36 months plus 6 months is this……….
Our plan does not require that group coverage be dropped once an employee becomes eligible for Medicare. For example, if you had become eligible for Medicare last February and you were still employed full time, our plan would not have required that you drop our Aetna plan and just go on Medicare. Some employers have plans that do require that you drop their plan and go only on Medicare once you are eligible for Medicare. Had you been required to drop our coverage, that would have been a qualifying event for your wife. She would have been entitled to 18 month plus 6 months. Then, continuing with this example of what if you had become eligible for Medicare a few months ago and lost our Aetna coverage…….after that, you retired from the school at the end of May. This would have been considered a second qualifying event and that would have entitled your wife to have COBRA coverage for 36 months plus 6 months.
The COBRA law says that she would only have been entitled to 36 months plus 6 months had you incurred a second qualifying event.
I have studied the Dept of Labor guide to COBRA. It seems clear to me that his enrollment in Medicare is a qualifying event for his wife, and entitles her to 36 months of COBRA. No mention of the rule quoted above that the termination of coverage had to be involuntary to qualify for the additional COBRA. And it seems clear that her extended eligibility is a first qualifying event with no requirement for a second.
I have been told by others in a similar situation that they got confirmation from benefits administrators that the spouse gets 36 months. I'm pretty sure this guy is not getting correct information, but never absolutely sure when it comes to these technical details around federal law. Any input on this from anyone?
Here is what I have concluded. I had this information confirmed with benefits administrator's COBRA department.
Your wife is eligible for 18 months of standard COBRA coverage, plus an additional 6 months of state continuation coverage. The reason she would not be eligible for 36 months plus 6 months is this……….
Our plan does not require that group coverage be dropped once an employee becomes eligible for Medicare. For example, if you had become eligible for Medicare last February and you were still employed full time, our plan would not have required that you drop our Aetna plan and just go on Medicare. Some employers have plans that do require that you drop their plan and go only on Medicare once you are eligible for Medicare. Had you been required to drop our coverage, that would have been a qualifying event for your wife. She would have been entitled to 18 month plus 6 months. Then, continuing with this example of what if you had become eligible for Medicare a few months ago and lost our Aetna coverage…….after that, you retired from the school at the end of May. This would have been considered a second qualifying event and that would have entitled your wife to have COBRA coverage for 36 months plus 6 months.
The COBRA law says that she would only have been entitled to 36 months plus 6 months had you incurred a second qualifying event.
I have studied the Dept of Labor guide to COBRA. It seems clear to me that his enrollment in Medicare is a qualifying event for his wife, and entitles her to 36 months of COBRA. No mention of the rule quoted above that the termination of coverage had to be involuntary to qualify for the additional COBRA. And it seems clear that her extended eligibility is a first qualifying event with no requirement for a second.
I have been told by others in a similar situation that they got confirmation from benefits administrators that the spouse gets 36 months. I'm pretty sure this guy is not getting correct information, but never absolutely sure when it comes to these technical details around federal law. Any input on this from anyone?
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