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- W57874008 abstract "I. INTRODUCTION In 1986 Congress passed Consolidated Omnibus Budget Reconciliation Act (COBRA).(2) This legislation amended Employee Retirement Income Security Act (ERISA)(3) by requiring employers to offer group health insurance coverage to terminated employees for a specific time period after termination. The purpose of this legislation was to provide for the growing number of Americans without any health insurance coverage and decreasing willingness of our Nation's hospitals to provide care to those who cannot afford to pay.(4) The statute requires that group health insurance coverage extend for eighteen months or thirty-six months, depending upon event, or until [t]he date on which becomes, after date of election, covered under any other group health plan.(5) There has been a split among Circuits as to meaning of first becomes statutory language and how this language should be applied when a terminated employee has preexisting coverage through his or her spouse's employer at time of termination and makes an election for COBRA continuation coverage. The Tenth and Seventh Circuits have held that employee is not disqualified from obtaining COBRA continuation coverage because of spouse's preexisting group health insurance coverage.(6) The Fifth, Eleventh, and Eighth Circuits, on other hand, have held that employee is disqualified from obtaining continuation coverage because of spouse's preexisting group health insurance coverage.(7) The Supreme Court recently decided Eighth Circuit case regarding issue of an employee's right to COBRA continuation coverage when employee has preexisting spousal coverage.(8) This Paper will discuss relevant statutes, case law and Supreme Court's opinion in Geissal v. Moore Medical Corp.(9) It concludes that Supreme Court correctly reversed Eighth Circuit's opinion in Geissal by applying plain meaning of statute and rejecting theory. James Geissal was entitled to COBRA continuation coverage even though his wife had preexisting group health insurance coverage. The Fifth, Eleventh and Eighth Circuits' significant theory is not supported by plain meaning of statute or Congress' intent. The employee should have choice to elect COBRA or decide whether different coverage is in his or her best interest. As long as employee bears risk and pays premiums during limited time period provided by COBRA courts should not supplant their own views as to what constitutes adequate coverage or whether there is a significant gap in health insurance coverage between employee's coverage and spouse's coverage. Part I of this paper will provide a background analysis of statutory provision at issue and discuss holdings of Circuit Courts of Appeal. Part II of this paper will analyze Geissal case. Part III of this paper will conclude that Supreme Court's opinion in Geissal case is only possible decision that could preserve plain meaning of statute and limit judicial intrusion into group health insurance arena. II. BACKGROUND A. COBRA The obligation to provide COBRA continuation coverage applies to employers with twenty or more employees.(10) The statute requires that qualified who would lose coverage under plan as a result of a is entitled, under plan, to elect within election period, continuation coverage under plan.(11) A qualified beneficiary is defined as individual employee or an individual, whom on day before for employee, is a plan as individual's spouse or dependent child.(12) A qualifying event is defined as an which would, but for continuation coverage provisions, result in loss of coverage for beneficiary. …" @default.
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- W57874008 date "2001-02-24" @default.
- W57874008 modified "2023-10-17" @default.
- W57874008 title "COBRA continuation coverage and the plain reading of the statute: Geissal v. Moore Medical Corporation." @default.
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