Qualified Beneficiaries Must Meet Plan’s Notice Requirements

November 30, 2016

If a qualified beneficiary or any family member of a qualified beneficiary is determined to be disabled by the Social Security Administration (“SSA”) during the first 60-days after the termination of employment or reduction of hours, the COBRA maximum coverage period extends from 18 months to 29 months. Plans may require that the qualified beneficiary provide notice within 60 days of the SSA’s disability determination and before the end of the original 18-month COBRA coverage period. The IRS recently issued a information letter addressing the situation where a qualified beneficiary received a disability determination from the SSA but did not meet the plan’s requirement to provide notice within 60 days. Consequently, the plan denied the request for extended COBRA coverage. The IRS stated that in this situation it was legal to deny the request for an extension of coverage and that plans are not required to extend the notification period beyond what is required by COBRA. It is important for plans to establish firm notice requirements and procedures to provide notice and communicate those to plan participants. If a notification period is not clearly communicated either in the SPD and/or COBRA initial notice the plan risks having an indefinite notice period.

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