| Congress passed the landmark Consolidated | | | | receiving continuation coverage. |
| Omnibus Budget Reconciliation Act (COBRA) | | | | While COBRA continuation coverage must be |
| health benefit provisions in 1986. The law amends | | | | offered, it lasts only for a limited period of time. |
| the Employee Retirement Income Security Act | | | | COBRA generally applies to all group health plans |
| (ERISA), the Internal Revenue Code, and the | | | | maintained by private-sector employers (with at |
| Public Health Service Act to require most group | | | | least 20 employees) or by state and local |
| health plans to provide a temporary continuation | | | | governments. The law does not apply, however, |
| of group health coverage that otherwise might be | | | | to plans sponsored by the Federal government or |
| terminated. | | | | by churches and certain church-related |
| COBRA requires continuation coverage to be | | | | organizations. |
| offered to covered employees, their spouses, | | | | Under COBRA, a group health plan is any |
| their former spouses, and their dependent children | | | | arrangement that an employer establishes or |
| when group health coverage would otherwise be | | | | maintains to provide employees or their families |
| lost due to certain specific events. | | | | with medical care, whether it is provided through |
| Those events include the death of a covered | | | | insurance, by a health maintenance organization, |
| employee, termination or reduction in the hours of | | | | out of the employer's assets on a pay-as-you-go |
| a covered employee's employment for reasons | | | | basis, or otherwise. "Medical care" for this purpose |
| other than gross misconduct, divorce, or legal | | | | includes: inpatient and outpatient hospital care, |
| separation from a covered employee, a covered | | | | physician care, surgery and other major medical |
| employee's becoming entitled to Medicare, and a | | | | benefits, prescription drugs, dental and vision care. |
| child's loss of dependent status (and therefore | | | | Life insurance is not considered "medical care," nor |
| coverage) under the plan. | | | | are disability benefits; and COBRA does not cover |
| Employers may require individuals who elect | | | | plans that provide only life insurance or disability |
| continuation coverage to pay the full cost of the | | | | benefits. Group health plans covered by COBRA |
| coverage, plus a 2 percent administrative charge. | | | | that are sponsored by private sector employers |
| The required payment for continuation coverage | | | | generally are governed by ERISA. ERISA does |
| is often more expensive than the amount that | | | | not require employers to establish plans or to |
| active employees are required to pay for group | | | | provide any particular type or level of benefits, |
| health coverage, since the employer usually pays | | | | but it does require plans to comply with ERISA's |
| part of the cost of employees' coverage and all | | | | rules, and ERISA gives participants and |
| of that cost can be charged to the individuals | | | | beneficiaries rights that are enforceable in court. |