ActiveStatutePrimary sourceSource ID usc-29-1163-qualifying-events

29 U.S.C. 1163 (what counts as a qualifying event for COBRA continuation)

Published by Office of the Law Revision Counsel, U.S. House of Representatives (uscode.house.gov). Jurisdiction US.

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  • Section 1163(1) lists the death of the covered employee as a qualifying event.

    claim usc-29-1163-qualifying-events#c1
  • Section 1163(2) lists the termination, other than by reason of the employee's gross misconduct, or reduction of hours, of the covered employee's employment.

    claim usc-29-1163-qualifying-events#c2
  • Section 1163(3) lists the divorce or legal separation of the covered employee from the employee's spouse.

    claim usc-29-1163-qualifying-events#c3
  • Section 1163(4) lists the covered employee becoming entitled to benefits under title XVIII of the Social Security Act.

    claim usc-29-1163-qualifying-events#c4
  • Section 1163(5) lists a dependent child ceasing to be a dependent child under the generally applicable requirements of the plan.

    claim usc-29-1163-qualifying-events#c5
  • Section 1163(6) lists a proceeding in a case under title 11, commencing on or after July 1, 1986, with respect to the employer from whose employment the covered employee retired at any time.

    claim usc-29-1163-qualifying-events#c6
  • Section 1163 provides that in the case of an event described in paragraph (6), a loss of coverage includes a substantial elimination of coverage with respect to a qualified beneficiary described in section 1167(3)(C) within one year before or after the date of commencement of the proceeding.

    claim usc-29-1163-qualifying-events#c7

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Reviewer notes

The gross misconduct carve-out in paragraph (2) is the only conduct-based exclusion in the list, and it is the provision most often asserted and least often defined. Note also that paragraphs (3) and (5), divorce or legal separation and a child ceasing to be a dependent, are the two events the statute makes the individual rather than the employer responsible for reporting, which is why they are the ones most often missed.

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