COBRA Rules When You Regain Medical Coverage

Important Updates

  1. (IRS) posted to the Federal Register, "Extension of Certain Timeframes for Employee Benefit Plans, Participants, and Beneficiaries Affected by the COVID–19 Outbreak." HMSA will adhere to the appropriate timeframe extensions related to COBRA, for those specific situations, until no longer applicable. The parameters of the COBRA law currently remain unchanged. For more information, visit the Help Center.

June 2023:

Previously, the Biden Administration announced a definitive end to both the COVID-19 public health emergency (May 11, 2023) and the national health emergency (April 10, 2023). The U.S. Department of Labor, as allowed by the Joint Rule, subsequently exercised its discretion to determine July 10, 2023, as the end date of the Outbreak Period (60 days after the end of the public health emergency date, May 11, 2023).

  • Individuals and plans with timeframes that are subject to the relief under the Notices will have the applicable periods under the Notices disregarded until the earlier of (a) one year from the date they were first eligible for relief, or (b) July 10, 2023 [the end of the Outbreak Period]. In no case will a disregarded period exceed one year.
  • After July 10, 2023, the timeframes for individuals and plans with periods that were previously disregarded under the Notices will resume.

If an employee covered by COBRA obtains new employer-sponsored group coverage that contains a pre-existing condition exclusion, the pre-existing condition exclusion period will be reduced by the amount of time the qualified beneficiary had “creditable” coverage (if any).

Creditable coverage means any of the following:

  • Most types of health plans or insurance coverage (including employer-sponsored group plans).
  • Medicare Part A or B.
  • Medicaid.
  • Health insurance under the federal government or the U.S. Armed Forces.
  • A medical care program of the Indian Health Service or of a tribal organization.
  • A state health benefits risk pool.
  • A public health plan as defined in government regulations.
  • A health benefit plan under section 5(e) of the Peace Corps Act.

The creditable coverage is applicable to the qualified beneficiary as of the enrollment date in the new employer-sponsored group plan, as long as there has been no interruption of coverage longer than 63 days.

For additional important information, we encourage you to read: