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§1163 Qualifying Event

Title 29 › CHAPTER 18 — EMPLOYEE RETIREMENT INCOME SECURITY PROGRAM › SUBCHAPTER I — PROTECTION OF EMPLOYEE BENEFIT RIGHTS › Subtitle B — Regulatory Provisions › part 6 — continuation coverage and additional standards for group health plans › § 1163

Last updated Sep 22, 2026|Official source

Summary

Lists the events that count as a qualifying event and would cause a covered employee’s qualified beneficiaries to lose coverage unless continuation coverage is offered. These events are: the employee’s death; job termination (not for gross misconduct) or a reduction in hours; divorce or legal separation; the employee becoming entitled to benefits under title XVIII of the Social Security Act; a child no longer meeting the plan’s dependent rules; and a title 11 bankruptcy against the employer starting on or after July 1, 1986, if the employee retired from that employer. For that bankruptcy, a loss of coverage also includes a substantial elimination of coverage for certain beneficiaries within one year before or after the proceeding, as described in section 1167(3)(C).

Title 29, §1163

Labor, Source: USLM XML via OLRC

For purposes of this part, the term “qualifying event” means, with respect to any covered employee, any of the following events which, but for the continuation coverage required under this part, would result in the loss of coverage of a qualified beneficiary:

(1)The death of the covered employee.

(2)The termination (other than by reason of such employee’s gross misconduct), or reduction of hours, of the covered employee’s employment.

(3)The divorce or legal separation of the covered employee from the employee’s spouse.

(4)The covered employee becoming entitled to benefits under title XVIII of the Social Security Act [42 U.S.C. 1395 et seq.].

(5)A dependent child ceasing to be a dependent child under the generally applicable requirements of the plan.

(6)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.

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) of this title within one year before or after the date of commencement of the proceeding.

Notes & Related Subsidiaries

Editorial Notes

References in Text

The Social Security Act, referred to in par. (4), is act Aug. 14, 1935, ch. 531, 49 Stat. 620. Title XVIII of the Social Security Act is classified generally to subchapter XVIII (§ 1395 et seq.) of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see section 1305 of Title 42 and Tables.

Amendments

1986—Pub. L. 99–509 added par. (6) and last sentence.

Statutory Notes and Related Subsidiaries

Effective Date

of 1986 AmendmentAmendment by Pub. L. 99–509 effective, except as otherwise provided, as if included in title X of the Consolidated Omnibus Budget Reconciliation Act of 1985, Pub. L. 99–272, see section 9501(e) of Pub. L. 99–509, set out as a note under section 162 of Title 26, Internal Revenue Code.