1. Overview

• COBRA
• Covered Group Health Plans
• Covered Employers
• Eligibility for COBRA Coverage
• What Is COBRA Coverage?
• Administration
• COBRA Premiums
• COBRA Enforcement, Penalties, and Remedies
• Multiemployer Group Health Plans
• Medicare and Its Relationship to COBRA
• COBRA Issues in Mergers and Acquisitions
• ERISA Preemption: State Continuation Coverage Laws and State Law Claims
• Coordination of COBRA and Other Health Benefits

2. Covered Group Health Plans

• General Rule
•  ‘‘Maintained’’ by an Employer or Employee Organization
• Definition of Group Health Plan
• Number of Group Health Plans
• Cafeteria Plans and Flexible Spending Accounts
• Health Reimbursement Arrangements and Health Savings Accounts
• Employee Assistance Programs
• Medical Savings Accounts
• Long-Term Care Plans
• Executive Physical Examination Programs
• Health Maintenance Organizations
• Self-Insured Plans
• Contributory and Noncontributory Plans
• Voluntary Employees’ Beneficiary Associations
• Collectively Bargained Plans
• Multiemployer Plans
• Multiple-Employer Welfare Arrangements

 3. Covered Employers

• General Rule
• Who Is the Employer Responsible for Providing COBRA Coverage?
• Exempt Employers: Small Employers
• Exempt Employers: Government Employers
• Exempt Employers: Church Plans

 4. Eligibility for COBRA Coverage

• Introduction
• Who Is Eligible for COBRA Coverage?
• Which Events Trigger COBRA Eligibility?
• When Is Group Health Plan Coverage Lost?

 5. What Is COBRA Coverage?

• The Concept of Continuing Coverage Under COBRA
• What Level of Benefits Must Be Continued?
• Rights of Qualified Beneficiaries
• How Long COBRA Coverage Must Last
• Termination of COBRA Coverage Prior to the End of the Maximum Coverage Period
• Coverage During the COBRA Election Period and Premium Payment Grace Period

6. Administration

• Required COBRA Notices
• Content of COBRA Notices
• When a Qualifying Event Occurs: Who Must Notify Whom?
• Providing COBRA Notices
• Receipt of COBRA Notice
• The Election Period
• Electing or Waiving COBRA Coverage

7. COBRA Premiums

• Calculation of COBRA Premiums
• Timing and Method of Premium Payments
• Who Makes the Premium Payments?
• Erroneous Acceptance of COBRA Premium Payments
• COBRA Premium Payments Under the Trade Act of 2002
• The ARPA and ARRA Premium Subsidies

 8. COBRA Enforcement, Penalties, and Remedies

• Overview of COBRA Remedies and Sanctions
• Division of Enforcement Authority
• Tax Penalty for COBRA Violations: Current Rule
• ERISA Penalty for Failure to Issue COBRA Notices
• Fiduciary Liability Under ERISA
• Civil and Criminal Liability Under ERISA
• Enforcement Actions Under ERISA
• COBRA Violations Under the Public Health Service Act
• Violations of the Continuation Coverage Provisions in the Uniformed Services Employment and Reemployment Rights Act

9. Multiemployer Group Health Plans

• What Constitutes a Multiemployer Plan?
• The Operation of Multiemployer Plans
• Which Entity Is Responsible for Providing Continuation Coverage Under a Multiemployer Plan When an Employer Ceases to Contribute to the Plan?
• Special COBRA Notice Rules for Multiemployer Group Health Plans
• Miscellaneous COBRA Rules Affecting Multiemployer Plans
• Application of COBRA Excise Tax Penalty Provisions to Multiemployer Plans
• Other Penalties Applicable to Multiemployer Plans
• Remedies

10. Medicare and Its Relationship to COBRA

• What Is Medicare?
• What Does Entitled to Medicare Mean?
• Effect of Medicare (or Medicaid) Entitlement on Eligibility for COBRA Coverage
• Medicare Entitlement as a COBRA Qualifying Event
• Medicare Entitlement as a COBRA Terminating Event
• Coordination of COBRA Coverage and Medicare

 11. COBRA Issues in Mergers and Acquisitions

• In General
• Stock and Asset Transactions
• COBRA Provisions in Purchase Agreements
• Issues Created by the Final M&A Regulations
• Small-Employer Exception to COBRA

 12. ERISA Preemption: State Continuation Coverage Laws and State Law Claims

• Federal and State Law
• What Is ERISA Preemption?
• Why Is ERISA Preemption Significant?
• Determining Whether a State Law Relates to ERISA Plans
• Determining Whether a State Law Is Exempt from Preemption Because It Regulates the Business of Insurance
• Determining Whether ERISA’s Deemer Clause Causes a State Insurance Law to Be Preempted from Applying to Self-Insured Plans
• Applicability of State Continuation Coverage Laws to ERISA-Covered Plans
• Integrating State Law and COBRA Continuation Coverage Requirements
• ERISA Preemption of State-Law Claims Related to COBRA Violations

 13. Coordination of COBRA Coverage and Other Health Benefits

• General COB Principles
• How Do COB Rules Relate to COBRA Coverage?
• COB Model Regulation
• Coordination of Group Health Plan Coverage with Medicare

Appendix A Regulations

• A-1 2004 DOL Final COBRA Regulations
• A-2 2001 IRS Final COBRA Regulations
• A-3 1999 IRS Final COBRA Regulations

Appendix B Model Notices

• B-1 Model COBRA Continuation Coverage General Notice
• B-2 Model COBRA Continuation Coverage Election Notice