In certain circumstances, if a disabled individual and non-disabled family members are qualified beneficiaries, they are eligible for up to an 11-month extension of COBRA continuation coverage, for a total of 29 months. The criteria for this 11-month disability extension is a complex area of COBRA law. We provide general information below, but if you have any questions regarding your disability and public sector COBRA, we encourage you to email us at phig@cms.hhs.gov.
In general, the COBRA qualifying event must be a termination of employment or a reduction of the covered employee’s employment hours. Second, the covered employee must be determined under title II or title XVI of the Social Security Act to be disabled. Third, the individual must be disabled at some time during the first 60 days of COBRA continuation coverage, regardless of whether the disability started prior to or during that period. Fourth, while the disability must begin within the first 60 days of COBRA coverage, the determination under title II or XVI can be issued any time during the 18-month period of COBRA coverage that began with the qualifying event. Finally, the covered employee must generally notify the plan administrator about the disability determination within 60 days after the date the disability determination is issued, but in no case later than the end of the 18-month period of continuation coverage that applies to the qualifying event. In addition, the extended period of COBRA ends if there is a final determination under title II or XVI that the individual is no longer disabled.
Note that the group health plan is permitted to charge up to 150 percent of the applicable premium for the 11-month extension. Questions about COBRA coverage and other health insurance alternatives? Contact your Total Benefit Solutions health insurance specialists at (215)355-2121