You can use the following eligibility profiles to determine COBRA participation.
| Description | Identifies the leave reason critiera that exclude a participant from COBRA eligibility. |
| Associated COBRA Compensation Object | Program |
| Include or Exclude? | Exclude |
| Required? | Yes |
| Comments | Use this criteria to exclude participants terminated for reasons of Gross Misconduct. |
| Description | This criteria excludes participants from COBRA eligibility who are ineligible for all plans subject to COBRA but who have coverage from another plan sponsor. |
| Associated COBRA Compensation Object | Program |
| Include or Exclude? | Exclude |
| Required? | No |
| Comments | Select a value of Yes in the Other Coverage field when defining this profile. The participant will be found eligible if they do not have other coverage. Use the People window to record if a person has other coverage. |
| Description | This criteria excludes a participant from COBRA eligibility who becomes entitled to Medicare benefits. |
| Associated COBRA Compensation Object | Program |
| Include or Exclude? | Exclude |
| Required? | No |
| Comments | Check the Opted for Medicare field and the Exclude field when defining this profile. Use the People window to record if a person is covered under Medicare. A participant who becomes entitled to Medicare as an active employee may become ineligible for both regular benefits and COBRA benefits. The dependents of an active employee who opts for Medicare become eligible for COBRA. If the participant who opts for Medicare is currently covered by COBRA, the participant's dependents can extend their COBRA coverage for 36 months if the initial COBRA qualifying event is Termination or Reduction in Hours. |
| Description | Use this criteria to find qualified beneficiaries eligible for coverage extensions based on qualifying events that occur during COBRA coverage, such as the death or divorce of the primary participant. |
| Associated COBRA Compensation Object | Program |
| Include or Exclude? | Include |
| Required? | No |
| Comments | Select a value of Yes in the Qualified Beneficiary field when defining this profile. This profile also prevents a qualified beneficiary from being found eligible once the maximum enrollment period is reached. |
| Description | You define this profile to exclude a participant from COBRA eligibility who is currently eligible for any plan subject to COBRA in a plan type that you include in the profile. |
| Associated COBRA Compensation Object | Plan Type in Program |
| Include or Exclude? | Exclude |
| Required? | Yes |
| Comments | Check the Subject to COBRA field when defining this eligibility profile so that the system only checks for plans in the plan type that are subject to COBRA. |
| Description | This criteria determines if the participant was enrolled in the plan type in program one day before the COBRA qualifying life event. |
| Associated COBRA Compensation Object | Plan Type in Program |
| Include or Exclude? | Include |
| Required? | Yes |
| Comments | Check the Subject to COBRA field when defining this eligibility profile so that the system only checks for plans in this plan type that are subject to COBRA. Select a Date Adjustment value of Date of Determination Minus 1 to determine if the participant was enrolled in any plans in the plan type one day before the COBRA qualifying life event. |
| Description | This criteria determines if the participant's dependents were covered by the plan type in program one day before the COBRA qualifying life event. |
| Associated COBRA Compensation Object | Plan Type in Program |
| Include or Exclude? | Include |
| Required? | Yes |
| Comments | Check the Subject to COBRA field when defining this eligibility profile so that the system only checks for plans in this plan type that are subject to COBRA. Select a Date Adjustment value of Date of Determination Minus 1 to determine if the dependent was covered in any plans in the plan type one day before the COBRA qualifying life event. |
| Description | This criteria determines if the participant was enrolled in the plan in program one day before the COBRA qualifying life event. |
| Associated COBRA Compensation Object | Plan in Program |
| Include or Exclude? | Include |
| Required? | |
| Comments | Select a Date Adjustment value of Date of Determination Minus 1 to determine if the participant was enrolled in this plan one day before the COBRA qualifying life event. |
| Description | This criteria determines if the participant's dependents were covered by the plan in program one day before the COBRA qualifying life event. |
| Associated COBRA Compensation Object | Plan in Program |
| Include or Exclude? | Include |
| Required? | |
| Comments | Select a Date Adjustment value of Date of Determination Minus 1 to determine if the dependent was covered by this plan in program one day before the COBRA qualifying life event. |
| Description | This criteria determines if a participant is currently eligible for any plans subject to COBRA. |
| Associated COBRA Compensation Object | Plan in Program |
| Include or Exclude? | Exclude |
| Required? | No |
| Comments | Check the Exclude field when defining this profile to determine that a participant who is eligible for this plan is ineligible for COBRA. |
| Description | This criteria determines if the participant was enrolled in the plan one day before the COBRA qualifying life event. |
| Associated COBRA Compensation Object | Plan |
| Include or Exclude? | Include |
| Required? | |
| Comments | Select a Date Adjustment value of Date of Determination Minus 1 to determine if the participant was enrolled in this plan one day before the COBRA qualifying life event. |
| Description | This criteria determines if the participant's dependents were covered by the plan one day before the COBRA qualifying life event. |
| Associated COBRA Compensation Object | Plan |
| Include or Exclude? | Include |
| Required? | |
| Comments | Select a Date Adjustment value of Date of Determination Minus 1 to determine if the dependent was covered by this plan one day before the COBRA qualifying life event. |
| Description | This criteria determines if the participant was enrolled in a COBRA program on the day of open enrollment. |
| Associated COBRA Compensation Object | COBRA Program |
| Include or Exclude? | Include |
| Required? | |
| Comments | Use this profile to limit eligibility for COBRA open enrollment periods to those participants currently enrolled in the COBRA program. Select a Date Adjustment value of Day of Determination to determine if the participant was enrolled in the program during the open enrollment period |
| Description | This criteria determines if the participant was enrolled in the plan in program one day before the COBRA qualifying life event. |
| Associated COBRA Compensation Object | Plan in Program |
| Include or Exclude? | Include |
| Required? | |
| Comments | Select a Date Adjustment value of Date of Determination Minus 1 to determine if the participant was enrolled in this plan in program one day before the COBRA qualifying life event. Select a Date Adjustment value of Day of Determination to determine if the participant was enrolled in the program during the open enrollment period |
| Description | This criteria determines if the participant was enrolled in the plan in program one day before the COBRA qualifying life event. |
| Associated COBRA Compensation Object | Plan in Program |
| Include or Exclude? | Include |
| Required? | |
| Comments | Select a Date Adjustment value of Date of Determination Minus 1 to determine if the participant was enrolled in this plan in program one day before the COBRA qualifying life event Select a Date Adjustment value of Day of Determination to determine if the participant was enrolled in the program during the open enrollment period. |
| Description | Use this criteria to exclude a participant from COBRA eligibility who was enrolled in the waive option of a plan one day prior to the COBRA qualifying life event. |
| Associated COBRA Compensation Object | Option in Plan in Program |
| Include or Exclude? | Exclude |
| Required? | This profile is only required if you define a plan subject to COBRA that contains a waive option. |
| Comments | Select a Date Adjustment value of Date of Determination Minus 1 to determine if the participant was enrolled in the waive option one day before the COBRA qualifying life event. |