Summary: Six events trigger COBRA rights: job loss, hours reduction, death, divorce, Medicare entitlement, and a child aging out. Each event creates rights for specific people and starts notice deadlines. This guide lists every qualifying event, who it covers, and the deadlines that protect the coverage.
COBRA is not one right but a bundle of rights triggered by specific events. Knowing which event applies to your situation determines who can continue coverage, for how long, and what notices you must send.
The six events below cover every situation the statute recognizes. If your situation is not on the list, COBRA does not apply.
The COBRA election notice is a legal document with required contents: the right to elect, the election deadline, the coverage options and premiums, the payment terms, and the duration rules. If the notice is missing required elements or arrives late, the election deadlines can extend, and botched notices are a common basis for disputes.
Read the notice the day it arrives and calendar every deadline it states. If the notice never arrives, that does not mean you have no rights; contact the plan administrator in writing and keep copies. The employer's failure to notify does not erase your election right, but you must assert it.
Keep the notice with your important documents for the entire COBRA period. You will need it when disputes arise about payment addresses, grace periods, or termination dates, and memories of what the notice said are worthless compared to the paper.
For the covered employee: termination of employment for any reason other than gross misconduct, and reduction of hours. For the spouse: the same two, plus the employee's death, divorce or legal separation, and the employee's entitlement to Medicare. For dependent children: all of the above plus losing dependent status under the plan, usually by aging out.
Gross misconduct is the only employment-related exclusion, and it is narrowly interpreted: ordinary poor performance or layoffs qualify. If an employer claims gross misconduct to deny COBRA, that determination can be challenged.
Qualified beneficiaries are the people with independent COBRA rights: the covered employee, the spouse, and dependent children covered under the plan on the day before the event. Each has an independent right to elect or decline COBRA; a spouse can continue while the employee declines, and vice versa.
Children born or adopted during COBRA coverage are treated as qualified beneficiaries. Domestic partners and other non-spouse dependents generally are not, unless the plan voluntarily extends rights. Check the plan documents for any voluntary extensions beyond the statute.
The employer must notify the plan administrator of the qualifying event within 30 days for employment termination, hours reduction, death, and Medicare entitlement. The plan administrator must then send the COBRA election notice to qualified beneficiaries within 14 days, for a combined 44 days from event to notice.
For divorce, legal separation, and children aging out, the employee or family must notify the plan, generally within 60 days. This is the deadline families miss most often, because no employer is tracking it for them.
Qualified beneficiaries have 60 days from the later of the qualifying event or the election notice to elect COBRA. The election is retroactive to the event date if you pay the back premiums, which means the 60-day window doubles as a free look: you can wait to see if you need care before committing.
After electing, the first premium payment is due within 45 days. Subsequent payments have at least a 30-day grace period. Late payment can terminate coverage retroactively, so treat premium deadlines as seriously as the election deadline.
Beyond gross misconduct, COBRA can end early if premiums are not paid, if the employer stops offering any group health plan, if you enroll in Medicare after electing COBRA, or if you become covered under another group plan. Each has technical conditions; the Medicare interaction in particular is worth professional guidance.
COBRA cannot be denied because of health status. Insurers and employers may not use claims history or expected costs to discourage election, though in practice nobody advertises the option enthusiastically.
Bankruptcy of the employer can create COBRA-like rights for retirees under separate provisions. Military reservists called to active duty have USERRA continuation rights that interact with COBRA. Trade-affected workers may qualify for the Health Coverage Tax Credit, which pays a share of the COBRA premium.
If your situation involves any of these overlays, get advice rather than relying on the standard rules. The interactions are genuinely complex and the dollars are large.
Free help exists: your state's insurance department answers continuation questions, and the federal DOL's benefits advisors take COBRA complaints and questions. Use them before paying a consultant. The DOL's askebsa portal takes benefits questions online, and state insurance departments publish continuation guides written for non-lawyers. Both are free, both answer faster than most paid advisors on these specific rules, and neither tries to sell you anything. Start with the state department; escalate to the DOL only if the plan administrator is unresponsive.
Six events: job loss (except gross misconduct), hours reduction, employee death, divorce/legal separation, Medicare entitlement, and a dependent child aging out.
Yes. Voluntary termination is a qualifying event; only gross misconduct disqualifies.
60 days from the later of the qualifying event or the election notice. Coverage is retroactive once elected and paid.
You do. For divorce, separation, and children aging out, the family must notify the plan within 60 days; the employer handles the other events.
Qualifying events per federal COBRA statute and DOL guidance. This guide is for planning only.