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Covered Persons - Not Qualified Beneficiaries

Reference Number: MTAS-895
Reviewed Date: 04/07/2020

Certain individuals may be added to a qualified beneficiary’s health plan coverage but not be entitled to the same rights as a qualified beneficiary. For example, a former dependent child of a covered employee could enroll under a group health plan as a qualified beneficiary, marry, opt to cover a new spouse, have a child and opt to cover the child all within 36 months of COBRA continuation coverage. Thus an employee’s grandchild could be enrolled in an employer’s group health plan under COBRA but not as a qualified beneficiary. The only way the grandchild could become covered is if the former dependent child, a qualified beneficiary, so elects. The former dependent child’s new spouse would not have any election rights, nor would the grandchild.

Another group of individuals who could become covered under COBRA continuation coverage, but who are not qualified beneficiaries, are former qualified beneficiaries. For example, employee Smith is married and terminates employment but elects to continue only single coverage. His spouse declines to continue any coverage. During a subsequent open-enrollment period, Smith enrolls his spouse. If the couple is divorced within the 18-month continuation period, Smith’s spouse could not continue health benefits because she is not a qualified beneficiary.