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42 U.S.C. § 300bb–5Election

submitted 82 years ago by Pub. L. 99-272 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 531 words · no verdicts yet

in plain englishAI-generated · not legal advice

The election period — at least 60 days — lets a qualified beneficiary choose continuation coverage after a qualifying event. Choosing coverage for yourself usually covers other qualified beneficiaries too, unless you say otherwise. Workers eligible for trade-adjustment assistance get a special, later chance to elect coverage.

(a) In general: (1) Election period — the "election period" is the span of time that: (A) starts no later than the date coverage ends under the plan because of a qualifying event; (B) lasts at least 60 days; and (C) ends no earlier than 60 days after the later of (i) the date described in (A), or (ii) for a beneficiary who gets the notice required by section 300bb–6(4), the date of that notice. (2) Effect of election on other beneficiaries — unless the election says otherwise, when certain qualified beneficiaries (described in section 300bb–8(3)(A)(i) or (B)) elect continuation coverage, that election automatically also covers every other qualified beneficiary who would otherwise lose coverage because of the same qualifying event. If the plan offers a choice of coverage types, each qualified beneficiary can pick separately among those types. (b) Temporary extension of COBRA election period for certain individuals: (1) In general — a "nonelecting TAA-eligible individual" can still elect continuation coverage during the 60 days that start on the first day of the month they become TAA-eligible, but only if they elect within 6 months of the date they lost coverage because of the trade-related job loss. (2) Commencement of coverage; no reach-back — coverage elected this way starts at the beginning of that 60-day window and does not cover any earlier period. (3) Preexisting conditions — the time between losing coverage due to the trade-related job loss and the start of that 60-day window is ignored when counting the 63-day gaps that matter under certain other insurance-portability laws. (4) Definitions — for this subsection: (A) "Nonelecting TAA-eligible individual" means a TAA-eligible individual who lost coverage due to a trade-related job loss and did not elect continuation coverage during the normal 60-day election period tied to that loss. (B) "TAA-eligible individual" means someone who is an eligible trade-adjustment-assistance recipient, or an eligible alternative trade-adjustment-assistance recipient, as defined under section 35(c) of title 26. (C) "TAA-related election period" means the normal 60-day election period that follows directly from a trade-related loss of coverage. (D) "TAA-related loss of coverage" means losing health coverage because of the job separation that made someone TAA-eligible.
the actual law source: uscode.house.gov ↗public domain
(a) In general

For purposes of this subchapter—

(1) Election period

The term “election period” means the period which—

(A)

begins not later than the date on which coverage terminates under the plan by reason of a qualifying event,

(B)

is of at least 60 days’ duration, and

(C)

ends not earlier than 60 days after the later of—

(i)

the date described in subparagraph (A), or

(ii)

in the case of any qualified beneficiary who receives notice under section 300bb–6(4) of this title, the date of such notice.

(2) Effect of election on other beneficiaries

Except as otherwise specified in an election, any election of continuation coverage by a qualified beneficiary described in subparagraph (A)(i) or (B) of section 300bb–8(3) of this title shall be deemed to include an election of continuation coverage on behalf of any other qualified beneficiary who would lose coverage under the plan by reason of the qualifying event. If there is a choice among types of coverage under the plan, each qualified beneficiary is entitled to make a separate selection among such types of coverage.

(b) Temporary extension of COBRA election period for certain individuals
(1) In general

In the case of a nonelecting TAA-eligible individual and notwithstanding subsection (a), such individual may elect continuation coverage under this subchapter during the 60-day period that begins on the first day of the month in which the individual becomes a TAA-eligible individual, but only if such election is made not later than 6 months after the date of the TAA-related loss of coverage.

(2) Commencement of coverage; no reach-back

Any continuation coverage elected by a TAA-eligible individual under paragraph (1) shall commence at the beginning of the 60-day election period described in such paragraph and shall not include any period prior to such 60-day election period.

(3) Preexisting conditions

With respect to an individual who elects continuation coverage pursuant to paragraph (1), the period—

(A)

beginning on the date of the TAA-related loss of coverage, and

(B)

ending on the first day of the 60-day election period described in paragraph (1),

shall be disregarded for purposes of determining the 63-day periods referred to in section 2701(c)(2),1section 1181(c)(2) of title 29, and section 9801(c)(2) of title 26.

(4) Definitions

For purposes of this subsection:

(A) Nonelecting TAA-eligible individual

The term “nonelecting TAA-eligible individual” means a TAA-eligible individual who—

(i)

has a TAA-related loss of coverage; and

(ii)

did not elect continuation coverage under this part 2 during the TAA-related election period.

(B) TAA-eligible individual

The term “TAA-eligible individual” means—

(i)

an eligible TAA recipient (as defined in paragraph (2) of section 35(c) of title 26), and

(ii)

an eligible alternative TAA recipient (as defined in paragraph (3) of such section).

(C) TAA-related election period

The term “TAA-related election period” means, with respect to a TAA-related loss of coverage, the 60-day election period under this part 2 which is a direct consequence of such loss.

(D) TAA-related loss of coverage

The term “TAA-related loss of coverage” means, with respect to an individual whose separation from employment gives rise to being an TAA-eligible individual, the loss of health benefits coverage associated with such separation.

Source credit: (July 1, 1944, ch. 373, title XXII, § 2205, as added Pub. L. 99–272, title X, § 10003(a), Apr. 7, 1986, 100 Stat. 235; amended Pub. L. 99–514, title XVIII, § 1895(d)(5)(C), Oct. 22, 1986, 100 Stat. 2939; Pub. L. 107–210, div. A, title II, § 203(e)(2), Aug. 6, 2002, 116 Stat. 970.)

history & why it existsrecord from the source credit
  • 1944Enacted · Pub. L. 99-272 · 100 Stat. 235
  • 1986Amended · Pub. L. 99-514 · 100 Stat. 2939
  • 2002Amended · Pub. L. 107-210 · 116 Stat. 970

A history note hasn’t been published yet. The record shows enactment by Pub. L. 99-272 on 1944-07-01.

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