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Library: Policy

OKDHS:2-1-78. Consolidated Omnibus Budget Reconciliation Act (COBRA)

Revised 6-1-04


     The Consolidated Omnibus Budget Reconciliation Act of 1986 (COBRA) provides that certain qualified beneficiaries who become ineligible due to a change in eligibility status, such as death of employee, divorce or legal separation from employee, or a dependent child(ren) who loses eligibility due to age or marriage, may continue coverage up to three years for health, dental, or both, under the group insurance plan.  The period is reduced to 18 months for a terminated employee and his or her dependent(s).  Coverage may extend to a maximum 29 months if the employee is disabled at the time of termination.

  • (1) COBRA continuation is only available to employees and dependents who were covered under the group insurance plan or a health maintenance organization (HMO) on the date of the change in eligibility status. 
  • (2) No evidence of insurability is required for continuation of coverage.
  • (3) The coverage for health, dental, or both, is identical to that provided on the date of the qualifying event. For example, if an employee is terminated and is covered under an HMO, coverage remains with that HMO unless the employee moves out of the HMO service area.
  • (4) Each covered beneficiary has the same rights and benefits as any similarly situated person for whom a qualifying event has not occurred.  The limitations and exclusions are the same to the extent that the rules and regulations comply with the mandates of COBRA.  If the Oklahoma Department of Human Services (OKDHS) rules and regulations are in non-compliance with COBRA, the federal law applies.
  • (5) Each qualified beneficiary is entitled to elect to continue health coverage.  The premium is based on the number of qualified beneficiaries electing to continue coverage.
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