COBRA High Five Part V: Qualifying Event Notices from Employees and Dependents

Newfront has officially joined WTW, combining a technology-native approach with global expertise to better serve our clients. Read more

COBRA High Five Part V: Qualifying Event Notices from Employees and Dependents

By Brian Gilmore | Published September 17, 2025

Question: What are the situations where an employee or dependent is required to provide notice to the plan of a COBRA qualifying event?

Short Answer: Employees or dependents are required to notify the plan within 60 days upon a loss of coverage caused by divorce or legal separation or loss of eligible dependent child status. They also have a 60-day notice requirement to notify the plan of a SSA disability determination (to extend to 29 months) or a second qualifying event (to extend to 36 months).

Did you know that “COBRA” stands for the “Consolidated Omnibus Budget Reconciliation Act of 1985”? While the law is often referred to as “of 1986” based on its enactment date, the actual title in the law is “of 1985”. Rep. Pete Stark (D-CA) is generally credited with drafting the legislation and spearheading its passage. In honor of the 40 th anniversary of COBRA’s introduction in Congress on July 31, 1985, we are exploring a_ “High Five” selection of five key COBRA issues that employers are still grappling with 40 years later. Enjoy!

General Rule: COBRA Qualifying Event for Continuation Coverage Individuals have the right to continue group health plan coverage through COBRA upon experiencing a “qualifying event,” which is a loss of coverage triggered by one of the prescribed COBRA triggering events. Individuals who experience a COBRA qualifying event are referred to as “qualified beneficiaries”. Group health plans subject to COBRA include medical, dental, vision, health FSA, HRA, most EAPs, and certain wellness programs and on-site medical clinics.

There are two requirements for a COBRA qualifying event:

Loss of group health plan coverage;
Caused by a COBRA triggering event.

Not all losses of coverage are a COBRA qualifying event. Qualified beneficiaries have COBRA continuation coverage rights only if they experience a qualifying event. The event causing the individual’s loss of coverage must be one of the listed triggering events set forth by COBRA to constitute a qualifying event.

The Qualifying Events Requiring Notice from the Employee/Dependent The primary COBRA triggering events are:

Covered Employee’s Termination of Employment (18 months)
Covered Employee’s Reduction of Hours (18 months)
Failure to Return from FMLA Leave (18 months)
Death of Covered Employee (36 months)
Divorce or Legal Separation (36 months)
Loss of Eligible Dependent Child Status (36 months)

Of these qualifying events the first four qualifying events do not require notice from the employee. In other words, the plan is automatically obligated to provide the COBRA election notice to the employee and/or dependents upon the occurrence of the qualifying events. The last two qualifying events require the employee or dependent to notify the plan that the event has occurred to preserve their COBRA rights.

60-Day Deadline to Provide Notice of Divorce/Legal Separation Loss of coverage caused by divorce or legal separation is a 36-month COBRA qualifying event. The employee or spouse must provide notice to the plan within 60 days of the loss of eligibility caused by the divorce or legal separation. Failure to do so will cause the spouse to lose their COBRA rights under the plan.

Unfortunately, this is a frequent pain point for employers on multiple fronts as late legal separation/divorce notifications are frustratingly common. Where the employee/spouse provides notice after the 60-day deadline, the spouse has lost COBRA rights for failure to timely notify the plan. In that situation, plan will provide a notice of unavailability of continuation coverage to inform the spouse of the loss of COBRA rights. Furthermore, employers in this situation also must grapple with how to address the extended period of ineligible coverage and whether any employee disciplinary action is warranted.

Legal Separation vs. Divorce Some health plans terminate a spouse’s eligibility at the point of legal separation (if any) prior to a final divorce. Loss of coverage caused by legal separation and divorce are both COBRA qualifying events. Where the plan terminates spousal eligibility at the point of legal separation (as opposed to requiring final divorce), and the employee and spouse have a court-ordered legal separation prior to the final divorce, the spouse loses eligibility at the point of the legal separation and must be removed at that point. In either case, the employee/spouse have the responsibility to notify the plan within 60 days of the legal separation/divorce.

60-Day Deadline to Provide Notice of Loss of Eligible Dependent Child Status Loss of coverage caused by loss of eligible dependent child status is a 36-month COBRA qualifying event. The employee or dependent must provide notice to the plan within 60 days of the loss of eligibility caused by the loss of eligible dependent child status. As with divorce/legal separation situations, failure to timely provide notice will cause the child to lose COBRA rights and trigger a notice of unavailability of continuation coverage.

Employers Can Play a Role: Automating the COBRA Election Notice Upon Child Reaching Age 26 The requirement for the employee/dependent to provide notice upon loss of eligibility to preserve the child’s COBRA rights is a common cause of consternation for the employee who is often unaware of this requirement. Employees often assume that the benefits administration system will track the child’s eligibility and automatically provide COBRA rights upon reaching the plan limit (e.g., age 26).

While this is not required by the COBRA rules, employers should consider adopting a process that conforms to this standard employee expectation. Having systems processes in place that automatically terminates coverage and trigger the COBRA election notice when a child ages out of eligibility streamlines the process for both parties. It also prevents potentially significant adverse employee relations issues that can arise where a child loses COBRA rights caused by failure to notify the plan within 60 days of reaching the plan’s age limit.

COBRA Initial Notice: Apprising Employees/Dependents of Notice Requirements The COBRA rules require that the plan provide a COBRA initial notice (also referred to as the “general notice”) to employees and their covered spouses within 90 days of enrollment in the plan.

The DOL model COBRA initial notice states, in bolded font to highlight this rule’s significance: “For all other qualifying events (divorce or legal separation of the employee and spouse or a dependent child’s losing eligibility for coverage as a dependent child) you must notify the Plan Administrator within 60 days after the qualifying event occurs.”

Another 60-Day Notice Deadline: Notice of SSA Disability Determination for Disability Extension The maximum COBRA coverage period may be extended to 29 months for disabled employees and their covered dependents (COBRA “qualified beneficiaries”) where the qualified beneficiary meets certain requirements.

The disability extension from 18 – 29 months is available where:

The COBRA qualifying event is the employee’s termination of employment or reduction in hours; and
The qualified beneficiary is determined by the Social Security Administration (SSA) to have been disabled at any time during the first 60 days of COBRA coverage.

The Employee/Dependent Notice Requirements to Qualify for the Disability Extension The qualified beneficiary must provide notice within the following timeframes:

The qualified beneficiary notifies the plan of the SSA determination within 60 days of the SSA determination; and
The qualified beneficiary notifies the plan of the SSA determination before the end of the 18-month standard maximum coverage period.

Another 60-Day Notice Deadline: Notice of Second Qualifying Event The COBRA second qualifying event rules permit a spouse or dependent qualified beneficiary to extend the COBRA maximum coverage period from 18 months to 36 months. The second qualifying event can be death of the employee, divorce or legal separation from the employee, or the child losing eligible dependent status.

There are three requirements for the spouse/dependents to take advantage of a second qualifying event:

The original qualifying event was the employee’s termination of employment or reduction of hours (18-month events);
Within that 18-month maximum coverage period, a second qualifying event occurs; and
The spouse or dependent notifies the plan within 60 days from the date of the second qualifying event.

Who Must Provide the Notice to the Plan? For purposes of a qualifying event, second qualifying event, or disability determination, the COBRA rules provide that the employee, covered dependent, or any representative acting on their behalf may provide the required notice to the plan.

Employer Obligation to Provide COBRA Election Notice: Shorter 14-Day Deadline When an employer receives notice of a qualifying event from an employee/dependent based on divorce, legal separation, or loss of eligible dependent child status, the employer has 14 days to provide the COBRA election notice.

Summary Although it is clearly spelled out in the COBRA initial notice, most employees and dependents are not aware of their affirmative notice obligations to preserve COBRA rights upon a divorce, legal separation, or loss of eligible dependent child status. Employers should make efforts to communicate these responsibilities to minimize the unfortunate situations where a dependent loses COBRA rights because the employee/dependent does not meet the 60-day notice deadline.