PRIA, Government Policy, Made Personal

Summary

Names the events that count as a "qualifying event" when a person could lose health plan coverage unless they get continuation coverage. A qualifying event includes the covered employee’s death; the employee losing their job or having hours cut (unless for gross misconduct); the employee getting divorced or legally separated; the employee becoming eligible for benefits under title XVIII of the Social Security Act; or a child no longer meeting the plan’s rules for a dependent.

Title 42, §300bb–3

The Public Health and Welfare, Source: USLM XML via OLRC

For purposes of this subchapter, 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 subchapter, 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.

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 this title. For complete classification of this Act to the Code, see section 1305 of this title and Tables.

§300bb–3 Qualifying Event

Summary

Title 42, §300bb–3

Notes & Related Subsidiaries

Editorial Notes

References in Text

Citations & Metadata