Eligible Individuals:

  • Be enrolled in a group health plan whose sponsoring employer has over 20 employees
  • Experience a qualifying event
  • Or must be a qualified beneficiary of the person experiencing the qualifying event

Qualified Beneficiary:

Anyone covered under a group health plan on the day before an event that causes loss of coverage including:

  • Participating employees, including part-time employees
  • Their spouses
  • Their dependents
  • Retirees (unless they are eligible for Medicare)
  • Partners in a partnership

Non-Eligible Individuals:

  • An employee who is not yet eligible for your group health plan
  • An eligible employee who declined to participate in your group health plan
  • An individual who is enrolled for benefits under Medicare

(Ref. United State Department of Labor)

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