The risk is in the timing, not the concept.
- General notice at plan entry and qualifying event notices on schedule
- Election period tracking and reminders
- Premium collection and remittance, including grace period handling
- Documentation retained for audit
- Washington continuation rules accounted for alongside federal COBRA
- Termination notices when continuation coverage ends
COBRA itself is straightforward: when someone loses coverage through a qualifying event, they get the right to continue it at their own cost for a defined period. The exposure comes from the mechanics — specific notices, specific deadlines, and the ability to prove years later that you sent them.
Miss a notice window and the potential consequences include statutory penalties and liability for claims the person would have had covered. This is not a task that rewards good intentions and a spreadsheet.
We help client groups coordinate with a professional COBRA administrator, with a defined process for notices, elections, premiums, and records. Accurate and timely information from the employer remains essential.
Check the plan and the employee count.
Federal COBRA generally covers private-sector group health plans when the employer had at least 20 employees on more than half of its typical business days in the previous calendar year. Count full-time employees and fractional part-time employees—not just people enrolled in medical coverage. Related-employer rules can matter. This is a different test from the ACA 50-FTE calculation.
State and local government plans generally follow public-sector COBRA rules overseen by CMS. Federal-government and certain church plans have different rules or exemptions. Medical, dental, and vision benefits can be subject to COBRA; life-only and disability-only benefits are not. Review the Department of Labor employer guide.
Below 20 employees does not answer every continuation question.
Washington requires insurers issuing group hospital or medical coverage to offer the policyholder an option to include a continuation provision. That is not an automatic, identical COBRA benefit for every small business. If the policy includes continuation, its contract sets the duration and rate.
We help review the actual policy and carrier procedure before you tell an employee what is available. Confirm whether the plan is insured or self-funded and which rules apply. Read Washington’s continuation-option law, RCW 48.21.250.
The event must cause a loss of plan coverage.
Qualified beneficiaries generally include an employee, spouse, or dependent child covered the day before the qualifying event. Each has an independent election right. Special rules can apply.
Employment ends or hours are reduced
Generally up to 18 months
A resignation, layoff, or termination other than for gross misconduct can trigger continuation rights when coverage is lost. A reduction in hours can also qualify when it causes a loss of eligibility. Covered employees and eligible family members may elect.
A family member loses eligibility
Generally up to 36 months
Death of the covered employee, divorce or legal separation, and a child losing dependent status can create rights for affected spouses or children. Medicare entitlement can also be a qualifying event for family members when it causes a coverage loss; Medicare timing rules need individual review.
An extension may apply
29 or 36 months in qualifying circumstances
A qualifying Social Security disability determination may extend an 18-month period to 29 months. A second qualifying event can extend coverage for eligible spouses and children to a total of 36 months. Specific conditions and timely notices apply; these are not automatic extensions. See CMS guidance on coverage periods and extensions.
Assign responsibilities before an event happens.
The employer
Maintain accurate employee and dependent records, identify coverage-loss dates, and report employer-known events promptly. Review the service agreement and monitor that the process is working. Hiring a vendor does not automatically remove the employer’s or plan administrator’s legal duties.
The plan administrator and service provider
Confirm who is the named plan administrator and which tasks a COBRA provider performs. The agreed workflow should cover notices, elections, premium tracking, carrier eligibility updates, required termination notices, and records of delivery.
Employees and family members
Follow the plan’s notice procedure for events such as divorce or loss of dependent status, make elections, and pay required premiums on time. Keep contact information current and retain copies of notices and payments.
Benefit Experts
We help coordinate your employer team, carrier, and COBRA administrator. We review how event reporting fits with enrollment and payroll, clarify contacts, and help resolve administrative questions. Legal disputes and difficult eligibility decisions should go to qualified counsel.
Track the trigger date—not just the number of days.
These are general federal rules for common single-employer situations, not a deadline calculator. Plan provisions, special circumstances, and applicable extensions can change the analysis.
General notice · usually 90 days
Provide the general notice to the covered employee and spouse within the first 90 days of plan coverage. Earlier election-notice requirements can affect this timing.
Employer event notice · generally 30 days
The employer generally has 30 days to notify the plan administrator of employer-known events such as termination, reduced hours, death, or Medicare entitlement. Confirm the applicable starting date and plan procedure.
Election notice · generally 14 or 44 days
The administrator generally sends the election notice within 14 days after receiving the qualifying-event notice. When the employer is also the administrator, a combined 44-day rule generally applies, measured from the event or coverage loss under the applicable rule.
Family event notice · at least 60 days
For divorce, legal separation, or a child losing dependent status, follow the plan’s reasonable notice procedure. The allowed period must be at least 60 days from the latest applicable event, coverage-loss, or notice-of-responsibility date.
Election decision · at least 60 days
Allow at least 60 days from the later of coverage loss or provision of the election notice. Do not assume the clock always begins on the last day worked.
Premiums · 45 days, then a grace period
The initial payment is due no earlier than 45 days after election. Subsequent payments have a grace period of at least 30 days. Initial premiums may cover more than one month. Verify notice and payment rules with the DOL employer FAQs.
Continuation is not a new, reduced-benefit plan.
What the participant pays
Participants generally pay the full plan cost, including the former employer share, plus an administrative charge of up to 2%. For example, a $700 total monthly cost could mean a $714 COBRA premium. Certain disability extensions permit up to 150%. Employers may subsidize coverage by agreement.
What the participant receives
Coverage generally matches that offered to similarly situated active participants. Changes to the active plan can apply to COBRA participants too. Coverage may end early for reasons permitted by law, including unpaid premiums or the employer ending all group health plans. Coordinate any termination and required notice with the administrator.
Keep a record from the event through the final premium.
- Document the event and actual coverage-loss date
- Confirm covered family members and current mailing addresses
- Retain notices, delivery records, elections, and correspondence
- Reconcile premiums and carrier coverage records
- Review open cases when plans renew or administrators change
Agree on who reports each event and how receipt is confirmed. Keep sensitive employee information in approved secure systems rather than ordinary website messages.
COBRA, answered.
Does COBRA apply to our business?
Federal COBRA generally applies based on at least 20 employees on more than half of typical business days in the previous calendar year, with part-time employees counted fractionally. Review employer aggregation and plan type. Smaller Washington employers should check whether their insured policy includes a continuation provision.
Who pays for continuation coverage?
The individual, and they can be charged up to 102 percent of the full premium to cover administration. The employer is not subsidising it unless you choose to as part of a severance arrangement.
What counts as a qualifying event?
Termination other than for gross misconduct, a reduction in hours below eligibility, divorce or legal separation, a dependent aging off the plan, and certain other events. Each carries its own notice timing.
What happens if we miss a notice?
Contact the plan administrator and qualified counsel promptly. Preserve the dates and records and determine the appropriate correction. Failures can create tax, penalty, and claims exposure; do not assume sending a late notice resolves every issue.
Does a fired employee qualify?
Generally, termination other than for gross misconduct can qualify if it causes coverage loss. Do not treat an ordinary performance-related dismissal as an automatic exception. Have counsel review any proposed gross-misconduct denial.
Can a spouse elect COBRA if the employee does not?
Yes, each qualified beneficiary generally has an independent election right. A covered spouse or dependent child may elect even if the former employee declines.
Does outsourcing COBRA remove our responsibilities?
No. The employer still needs to supply timely and accurate information, follow the agreement, and oversee the process. Confirm who is the named plan administrator and who is responsible for each notice and record.
Verify the rules for your plan.
Reviewed September 16, 2026. This page is general education, not legal or tax advice. Plan documents, applicable law, and the facts of an event control. Seek counsel for missed deadlines, gross misconduct, mergers, and severance arrangements.
Primary references: DOL employer guide, CMS continuation coverage guidance, and Washington RCW 48.21.250.
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