COBRA Outline

Lesson 1: Introduction to COBRA

1. Legal Background of COBRA
2. Basic COBRA Requirements
3. Penalties for COBRA Compliance Failures
4. Effect of State Mini-COBRA Laws

Lesson 2: What Plan Sponsors and Plans Must Comply With COBRA?

1. Who Is Responsible for COBRA Compliance?
   1. Who Is the Plan Administrator?
   2. Who Is an Employer?
2. What Is a Group Health Plan?
3. Which Group Health Plans Are Subject to COBRA?
   1. Small Employer Plans
   2. How Are Employees Counted?
   3. Church Plans
   4. Federal Government Plans
4. How Is the Number of Group Health Plans Determined?
5. How Does COBRA Apply to Health Flexible Spending Accounts?
   1. Excepted Coverage
      1. Maximum Benefit Rule
      2. Availability Rule
   2. Limited COBRA
      1. Overspent Accounts
      2. Underspent Accounts
   3. Health FSAs

Lesson 3: Who is Entitled to COBRA?

1. In General, Who Is a Qualified Beneficiary?
2. Who Is an Employee and Who Is a Covered Employee?
   1. Who Is an Employee?
   2. Who Is a Covered Employee?
3. Who Is a Spouse and Who Is a Dependent Child?
   1. Who Is a Spouse?
   2. Who Is a Dependent Child?
4. Can Anyone Who Was Not Covered by the Group Health Plan on the Day Before the Qualifying Event Ever Become a Qualified Beneficiary?
5. Can a Non-COBRA Beneficiary Ever Receive COBRA Coverage?
6. When Does An Individual Cease To Be a Qualified Beneficiary?
7. Who Are "Similarly Situated Non-COBRA Beneficiaries”?
8. Reprise:  Who Is a Qualified Beneficiary?

Lesson 4: What Triggers the Obligation to Offer COBRA?

1. What Is a Qualifying Event?
   1. Reduction in Hours/Termination of Employment
   2. Employee’s Death
   3. Employee’s Divorce or Legal Separation
   4. Employee’s Medicare Entitlement
   5. Child’s Loss of Dependency Status
   6. Chapter 11 Bankruptcy Proceedings
2. What Is a Loss of Coverage?
3. How Long Is the Maximum COBRA Period?
4. How Does the Family and Medical Leave Act (FMLA) Affect COBRA Rights?

Lesson 5: How Long Does COBRA Coverage last?

1. How Long Is the Maximum COBRA Coverage Period?
2. When Does the COBRA Coverage Period Begin?
   1. General Rule
   2. Alternate Rule
   3. After-Acquired Qualified Beneficiaries
3. Under What Circumstances May the Maximum COBRA Coverage Period Be Extended Beyond 18 Months?
   1. Medicare Entitled Covered Employees
   2. Social Security Disability Extension
   3. Multiple Qualifying Events, Second Qualifying Event
4. Under What Circumstances May a Group Health Plan Terminate COBRA Coverage Before the Maximum COBRA Coverage Period Has Expired?

Lesson 6: What Is COBRA Coverage?

1. What Is COBRA Coverage?
2. If a Qualified Beneficiary Elects COBRA, How Do Plan Deductibles Apply?
3. If a Qualified Beneficiary Elects COBRA, How Do Plan Limits and Maximums Apply?
4. Can a Qualified Beneficiary Ever Change Coverage Options After Electing COBRA?
5. How Does the Election of Other Continued Coverage (e.g., Retiree Health Coverage) Affect a Qualified Beneficiary's COBRA Rights?
   1. Concurrent Coverage
   2. Consecutive Coverage
   3. Alternative Coverage
6. How Do the Requirements to Continue Group Health Coverage Under USERRA Affect COBRA?
   1. Substantive Differences
   2. Notice, Election and Payment

Lesson 7: Who Must Provide COBRA Notices and When?

1. What Is the General COBRA Notice?
   1. When and to Whom Is the General COBRA Notice Provided?
   2. How Is the General COBRA Notice Provided?
2. What Is the COBRA Election Notice?
   1. When and to Whom Is the COBRA Election Notice Provided?
   2. How Is the COBRA Election Notice Provided?
3. What Is the COBRA Unavailability Notice?
   1. A. When and to Whom Is the COBRA Unavailability Notice Provided?
   2. B. How Is the COBRA Unavailability Notice Provided?
4. What Is the COBRA Early Termination Notice?
   1. A. When and to Whom Is the COBRA Early Termination Notice Provided?
   2. B. How Is the COBRA Early Termination Notice Provided?
5. Must a Group Health Plan Provide a Conversion Notice When the Maximum COBRA Coverage Period Expires?
6. What Notices, if Any, Must a Qualified Beneficiary Provide to a Group Health Plan?
   1. A. Reasonable Procedures
   2. B. Notices With Information Missing
7. Consequences for Failure to Provide Notice Procedures

Lesson 8: How and When Can a Qualified Beneficiary Elect COBRA?

1. When Does the COBRA Election Period Begin and End?
2. When Is a COBRA Election Effective?
3. Who Can Elect COBRA on Behalf of a Qualified Beneficiary?
4. If a Qualified Beneficiary Initially Waives COBRA, Can He or She Retract the Waiver?
5. During the Election Period, Must Health Coverage Be Continued?
   1. A. Indemnity/Reimbursement Plans

Lesson 9: How and When Must a Qualified Beneficiary Pay for COBRA?

1. How Much Can a Group Health Plan Charge for COBRA Coverage?
   1. Applicable Premium
   2. Social Security Disability Extension
2. When Are Payments Due?
   1. Payment Periods
   2. Initial Payment
   3. Grace Periods
3. When Is a Payment Effectively Made?
   1. Late Payments
4. What Are the Group Health Plan's Obligations If a Payment Is for Less Than the Correct Amount?