The University of Tennessee, Knoxville

Tennessee County Municipal Advisory Service

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COBRA and Health Care Reform

Reference Number: MTAS-1545
Tennessee Code Annotated
Reviewed Date: June 03, 2016
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Health care reform, also called the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Affordability Reconciliation Act of 2010, was passed in March 2010. Health care reform allows dependent children to be re-added and covered under a parent’s health plan until their 26th birthday. While Health Care Reform doesn’t change the basic rules of COBRA, it will mean many more COBRA qualifying events and notices occurring as dependents are removed from COBRA and other plans and placed back on their parents’ plans. This means new notices must be sent, and new dependents will qualify under the provisions of COBRA should they experience a “qualifying event.” For some entities, this means adding and transitioning dozens of dependents from COBRA status to active status, or ineligible status to eligible status (which then makes them COBRA eligible if they experience a qualifying event). This means more notices and requires paying careful attention to COBRA timeframes. A large county in Middle Tennessee reported adding 500 dependents as a result of the new legislation.

In addition to the challenges presented related to transitioning dependents, the implementation of PPACA (and its integration with COBRA) offered additional technical challenges. The U.S. Dept. of Labor, in its Technical Release No. 2013-02 (, discussed changes to its Model Election Notice that communicate to the covered individual(s) their availability of marketplace coverages.