One of the biggest changes of the 2004 Final Rules concerns cases of divorce, legal separation, loss of dependent status or the employee’s entitlement to Medicare. This notice, required by the May 26, 2004, final notice regulations, mandates that the plan administrator send to covered employees and QBs a notice that includes an explanation of why an individual is not eligible for COBRA. This also could apply to events that are classified as “second qualifying events.”
If a plan administrator receives notice of a qualifying event, or even a second qualifying event, and determines that the individual is not entitled to COBRA or a disability extension, the plan administrator also must provide a notice to the individual explaining the reason for the denial. This notice does not apply to events in which the employer is required to notify the plan administrator such as termination of employment, reduction in work hours, death or enrollment in Medicare. This must be sent out in the same time frame as the plan would have sent the election notice.
The Department of Labor provides examples of triggering events that would require that the new notice of unavailability be sent. Examples include when the employee or QB fails to notify the employer of one of the above events or does not notify the employer/plan administrator in a timely manner. The employer/plan administrator then would be required to send the notice describing the reason for denying continuation of coverage within 14 days.
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