42 U.S.C. § 300bb–8 — Definitions

submitted 82 years ago by Pub. L. 99-272 to r/title-42-THE-PUBLIC-HEALTH-AND-WELFARE · 266 words · no verdicts yet

in plain englishAI-generated · not legal advice

This section defines the key COBRA terms: group health plan, covered employee, qualified beneficiary, and plan administrator. A qualified beneficiary is usually the employee's spouse or dependent child, though a job-loss event also covers the employee. Long-term-care and certain small reimbursement plans don't count as group health plans.

(1) Group health plan: This term has the meaning given in section 5000(b) of title 26. It does not include a plan that's substantially all long-term care coverage (as section 7702B(c) of title 26 defines it), and it does not include a qualified small employer health reimbursement arrangement (as section 9831(d)(2) of title 26 defines it). (2) Covered employee: This means someone who is or was covered under a group health plan because they performed services for one or more people who maintain the plan — including someone counted as an employee under section 401(c)(1) of title 26. (3) Qualified beneficiary: (A) In general — this means, for a covered employee under a group health plan, any other person who was a beneficiary under the plan the day before that employee's qualifying event, either (i) as the employee's spouse, or (ii) as the employee's dependent child. It also includes a child born to, or placed for adoption with, the covered employee during a period of continuation coverage. (B) Special rule for terminations and reduced employment — for a qualifying event that is a job termination or reduced hours (section 300bb–3(2)), "qualified beneficiary" also includes the covered employee. (4) Plan administrator: This term has the meaning given to "administrator" in section 1002(16)(A) of title 29.

the actual law source: uscode.house.gov ↗public domain

For purposes of this subchapter—

(1) Group health plan

The term “group health plan” has the meaning given such term in 5000(b) 1 of title 26. Such term shall not include any plan substantially all of the coverage under which is for qualified long-term care services (as defined in section 7702B(c) of title 26). Such term shall not include any qualified small employer health reimbursement arrangement (as defined in section 9831(d)(2) of title 26).

(2) Covered employee

The term “covered employee” means an individual who is (or was) provided coverage under a group health plan by virtue of the performance of services by the individual for 1 or more persons maintaining the plan (including as an employee defined in section 401(c)(1) of title 26).

(3) Qualified beneficiary

(A) In general

The term “qualified beneficiary” means, with respect to a covered employee under a group health plan, any other individual who, on the day before the qualifying event for that employee, is a beneficiary under the plan—

(i)

as the spouse of the covered employee, or

(ii)

as the dependent child of the employee.

Such term shall also include a child who is born to or placed for adoption with the covered employee during the period of continuation coverage under this subchapter.

(B) Special rule for terminations and reduced employment

In the case of a qualifying event described in section 300bb–3(2) of this title, the term “qualified beneficiary” includes the covered employee.

(4) Plan administrator

The term “plan administrator” has the meaning given the term “administrator” by section 1002(16)(A) of title 29.

Source credit: (July 1, 1944, ch. 373, title XXII, § 2208, as added Pub. L. 99–272, title X, § 10003(a), Apr. 7, 1986, 100 Stat. 236; amended Pub. L. 100–647, title III, § 3011(b)(7), Nov. 10, 1988, 102 Stat. 3625; Pub. L. 101–239, title VI, § 6801(c)(1), Dec. 19, 1989, 103 Stat. 2297; Pub. L. 104–191, title I, § 102(d), title III, § 321(d)(3), title IV, § 421(a)(3), Aug. 21, 1996, 110 Stat. 1978, 2059, 2088; Pub. L. 114–255, div. C, title XVIII, § 18001(c)(2), Dec. 13, 2016, 130 Stat. 1344.)

history & why it existsrecord from the source credit

1944Enacted · Pub. L. 99-272 · 100 Stat. 236
1988Amended · Pub. L. 100-647 · 102 Stat. 3625
1989Amended · Pub. L. 101-239 · 103 Stat. 2297
1996Amended · Pub. L. 104-191 · 110 Stat. 1978, 2059, 2088
2016Amended · Pub. L. 114-255 · 130 Stat. 1344

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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