# § 1162. Continuation coverage
For purposes of section 1161 of this title, the term “continuation coverage” means coverage under the plan which meets the following requirements:
**(1)** **Type of benefit coverage** The coverage must consist of coverage which, as of the time the coverage is being provided, is identical to the coverage provided under the plan to similarly situated beneficiaries under the plan with respect to whom a qualifying event has not occurred. If coverage is modified under the plan for any group of similarly situated beneficiaries, such coverage shall also be modified in the same manner for all individuals who are qualified beneficiaries under the plan pursuant to this part in connection with such group.
**(2)** **Period of coverage** The coverage must extend for at least the period beginning on the date of the qualifying event and ending not earlier than the earliest of the following:
**(A)** **Maximum required period**
**(i)** **General rule for terminations and reduced hours** section 1163(2) of this title
In the case of a qualifying event described in , except as provided in clause (ii), the date which is 18 months after the date of the qualifying event.
**(ii)** **Special rule for multiple qualifying events** section 1163(6) of this titlesection 1163(2) of this titlesection 1163(2) of this title
If a qualifying event (other than a qualifying event described in ) occurs during the 18 months after the date of a qualifying event described in , the date which is 36 months after the date of the qualifying event described in .
**(iii)** **Special rule for certain bankruptcy proceedings** section 1163(6) of this titlesection 1167(3)(C)(iii) of this title
In the case of a qualifying event described in (relating to bankruptcy proceedings), the date of the death of the covered employee or qualified beneficiary (described in ), or in the case of the surviving spouse or dependent children of the covered employee, 36 months after the date of the death of the covered employee.
**(iv)** **General rule for other qualifying events** In the case of a qualifying event not described in section 1163(2) or 1163(6) of this title, the date which is 36 months after the date of the qualifying event.
**(v)** **Special rule for PBGC recipients** section 1163(2) of this titleJanuary 1, 2014
In the case of a qualifying event described in with respect to a covered employee who (as of such qualifying event) has a nonforfeitable right to a benefit any portion of which is to be paid by the Pension Benefit Guaranty Corporation under subchapter III, notwithstanding clause (i) or (ii), the date of the death of the covered employee, or in the case of the surviving spouse or dependent children of the covered employee, 24 months after the date of the death of the covered employee. The preceding sentence shall not require any period of coverage to extend beyond .
**(vi)** **Special rule for TAA-eligible individuals** section 1163(2) of this titlesection 1165(b)(4)(B) of this titleJanuary 1, 2014
In the case of a qualifying event described in with respect to a covered employee who is (as of the date that the period of coverage would, but for this clause or clause (vii), otherwise terminate under clause (i) or (ii)) a TAA-eligible individual (as defined in ), the period of coverage shall not terminate by reason of clause (i) or (ii), as the case may be, before the later of the date specified in such clause or the date on which such individual ceases to be such a TAA-eligible individual. The preceding sentence shall not require any period of coverage to extend beyond .
**(vii)** **Medicare entitlement followed by qualifying event** section 1163(2) of this title42 U.S.C. 1395
In the case of a qualifying event described in that occurs less than 18 months after the date the covered employee became entitled to benefits under title XVIII of the Social Security Act [ et seq.], the period of coverage for qualified beneficiaries other than the covered employee shall not terminate under this subparagraph before the close of the 36-month period beginning on the date the covered employee became so entitled.
**1** **Special rule for disability** 42 U.S.C. 401[^1]
In the case of a qualified beneficiary who is determined, under title II or XVI of the Social Security Act [ et seq., 1381 et seq.], to have been disabled at any time during the first 60 days of continuation coverage under this part, any reference in clause (i) or (ii) to 18 months is deemed a reference to 29 months (with respect to all qualified beneficiaries), but only if the qualified beneficiary has provided notice of such determination under section 1166(3) of this title before the end of such 18 months.
See References in Text note below.
**(B)** **End of plan** The date on which the employer ceases to provide any group health plan to any employee.
**(C)** **Failure to pay premium** The date on which coverage ceases under the plan by reason of a failure to make timely payment of any premium required under the plan with respect to the qualified beneficiary. The payment of any premium (other than any payment referred to in the last sentence of paragraph (3)) shall be considered to be timely if made within 30 days after the date due or within such longer period as applies to or under the plan.
**(D)** **Group health plan coverage or medicare entitlement** The date on which the qualified beneficiary first becomes, after the date of the election—
**(i)** covered under any other group health plan (as an employee or otherwise) which does not contain any exclusion or limitation with respect to any preexisting condition of such beneficiary (other than such an exclusion or limitation which does not apply to (or is satisfied by) such beneficiary by reason of chapter 100 of title 26, part 7 of this subtitle, or title XXVII of the Public Health Service Act [42 U.S.C. 300gg et seq.]), or
**(ii)** in the case of a qualified beneficiary other than a qualified beneficiary described in section 1167(3)(C) of this title, entitled to benefits under title XVIII of the Social Security Act [42 U.S.C. 1395 et seq.].
**(E)** **Termination of extended coverage for disability** 42 U.S.C. 401
In the case of a qualified beneficiary who is disabled at any time during the first 60 days of continuation coverage under this part, the month that begins more than 30 days after the date of the final determination under title II or XVI of the Social Security Act [ et seq., 1381 et seq.] that the qualified beneficiary is no longer disabled.
**2** **Premium requirements** The plan may require payment of a premium for any period of continuation coverage, except that such premium—
In no event may the plan require the payment of any premium before the day which is 45 days after the day on which the qualified beneficiary made the initial election for continuation coverage. In the case of an individual described in the last sentence of paragraph (2)(A),[^2] any reference in subparagraph (A) of this paragraph to “102 percent” is deemed a reference to “150 percent” for any month after the 18th month of continuation coverage described in clause (i) or (ii) of paragraph (2)(A).
**(A)** shall not exceed 102 percent of the applicable premium for such period, and
**(B)** may, at the election of the payor, be made in monthly installments.
See References in Text note below.
**(4)** **No requirement of insurability** The coverage may not be conditioned upon, or discriminate on the basis of lack of, evidence of insurability.
**(5)** **Conversion option** In the case of a qualified beneficiary whose period of continuation coverage expires under paragraph (2)(A), the plan must, during the 180-day period ending on such expiration date, provide to the qualified beneficiary the option of enrollment under a conversion health plan otherwise generally available under the plan.
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**Source Credit**: (Pub. L. 93–406, title I, § 602, as added Pub. L. 99–272, title X, § 10002(a), Apr. 7, 1986, 100 Stat. 228; amended Pub. L. 99–509, title IX, § 9501(b)(1)(B), (2)(B), Oct. 21, 1986, 100 Stat. 2076, 2077; Pub. L. 99–514, title XVIII, § 1895(d)(1)(B), (2)(B), (3)(B), (4)(B), Oct. 22, 1986, 100 Stat. 2936–2938; Pub. L. 101–239, title VI, § 6703(a), (b), title VII, §§ 7862(c)(3)(B), (4)(A), (5)(B), 7871(c), Dec. 19, 1989, 103 Stat. 2296, 2432, 2433, 2435; Pub. L. 104–188, title I, § 1704(g)(1)(B), Aug. 20, 1996, 110 Stat. 1880; Pub. L. 104–191, title IV, § 421(b)(1), Aug. 21, 1996, 110 Stat. 2088; Pub. L. 111–5, div. B, title I, § 1899F(a), Feb. 17, 2009, 123 Stat. 428; Pub. L. 111–344, title I, § 116(a), Dec. 29, 2010, 124 Stat. 3615; Pub. L. 112–40, title II, § 243(a)(1), (2), Oct. 21, 2011, 125 Stat. 420.)
## Editorial Notes
### References in Text
The Social Security Act, referred to in par. (2)(A)(vii), (viii), (D)(ii), (E), is , . Titles II, XVI, and XVIII of the Social Security Act are classified generally to subchapters II (§ 401 et seq.), XVI (§ 1381 et seq.), and XVIII (§ 1395 et seq.), respectively, of chapter 7 of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see and Tables.
, referred to in par. (2)(A)(viii), was redesignated as by , , .
The Public Health Service Act, referred to in par. (2)(D)(i), is , . Title XXVII of the Act is classified generally to subchapter XXV (§ 300gg et seq.) of chapter 6A of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see Short Title note set out under and Tables.
The last sentence of paragraph (2)(A), referred to in par. (3), probably means par. (2)(A)(viii) of this section, which was originally enacted as the concluding provisions of par. (2)(A) and subsequently designated as cl. (vi) and redesignated as cl. (viii) of par. (2)(A) by , (3), , .
### Amendments
2011—Par. (2)(A)(v), (vi). substituted “” for “”.
2010—Par. (2)(A)(v), (vi). substituted “” for “”.
2009—Par. (2)(A)(v). , added cl. (v). Former cl. (v) redesignated (vii).
, transferred cl. (v) to appear after cl. (iv). See 1989 Amendment note below.
Par. (2)(A)(vi). , added cl. (vi). Former cl. (vi) redesignated (viii).
, designated concluding provisions as cl. (vi) and inserted heading.
Par. (2)(A)(vii), (viii). , redesignated cls. (v) and (vi) as (vii) and (viii), respectively.
1996—Par. (2)(A). , in closing provisions, substituted “In the case of a qualified beneficiary” for “In the case of an individual” and “at any time during the first 60 days of continuation coverage under this part” for “at the time of a qualifying event described in ”, struck out “with respect to such event” after “(ii) to 18 months”, and inserted “(with respect to all qualified beneficiaries)” after “29 months”.
Par. (2)(A)(v). amended cl. (v) generally. Prior to amendment, cl. (v) read as follows:
“(v) .—In the case of an event described in (without regard to whether such event is a qualifying event), the period of coverage for qualified beneficiaries other than the covered employee for such event or any subsequent qualifying event shall not terminate before the close of the 36-month period beginning on the date the covered employee becomes entitled to benefits under title XVIII of the Social Security Act.”
Par. (2)(D)(i). , inserted “(other than such an exclusion or limitation which does not apply to (or is satisfied by) such beneficiary by reason of chapter 100 of title 26, part 7 of this subtitle, or title XXVII of the Public Health Service Act [ et seq.])” before “, or” at end.
Par. (2)(E). , substituted “at any time during the first 60 days of continuation coverage under this part” for “at the time of a qualifying event described in ”.
1989—Par. (2)(A). , inserted after and below cl. (iv) “In the case of an individual who is determined, under title II or XVI of the Social Security Act, to have been disabled at the time of a qualifying event described in , any reference in clause (i) or (ii) to 18 months with respect to such event is deemed a reference to 29 months, but only if the qualified beneficiary has provided notice of such determination under before the end of such 18 months.”
Par. (2)(A)(iii). , substituted “described in section 1163(6)” for “described in 1163(6)”.
Par. (2)(A)(v). , added cl. (v) after concluding provisions inserted by . See above.
Par. (2)(D). , substituted “entitlement” for “eligibility” in heading and inserted “which does not contain any exclusion or limitation with respect to any preexisting condition of such beneficiary” after “or otherwise)” in cl. (i).
Par. (2)(E). , added subpar. (E).
Par. (3). , which directed substitution of “In no event may the plan require the payment of any premium before the day which is 45 days after the day on which the qualified beneficiary made the initial election for continuation coverage.” for last sentence of par. (3), was executed by making the substitution for the following sentence: “If an election is made after the qualifying event, the plan shall permit payment for continuation coverage during the period preceding the election to be made within 45 days of the date of the election.”, notwithstanding the sentence added at the end of par. (3) by .
, inserted at end “In the case of an individual described in the last sentence of paragraph (2)(A), any reference in subparagraph (A) of this paragraph to ‘102 percent’ is deemed a reference to ‘150 percent’ for any month after the 18th month of continuation coverage described in clause (i) or (ii) of paragraph (2)(A).”
1986—Par. (1). , inserted “If coverage is modified under the plan for any group of similarly situated beneficiaries, such coverage shall also be modified in the same manner for all individuals who are qualified beneficiaries under the plan pursuant to this part in connection with such group.”
Par. (2)(A). , amended subpar. (A) generally. Prior to amendment, subpar. (A) read as follows:
“(A) .—In the case of—
“(i) a qualifying event described in (relating to terminations and reduced hours), the date which is 18 months after the date of the qualifying event, and
“(ii) any qualifying event not described in clause (i), the date which is 36 months after the date of the qualifying event.”
Par. (2)(A)(ii). , inserted “(other than a qualifying event described in )”.
Par. (2)(A)(iii). , added cl. (iii). Former cl. (iii) redesignated (iv).
Par. (2)(A)(iv). , (iii), redesignated cl. (iii) as (iv) and inserted “or 1163(6)”.
Par. (2)(C). , inserted “The payment of any premium (other than any payment referred to in the last sentence of paragraph (3)) shall be considered to be timely if made within 30 days after the date due or within such longer period as applies to or under the plan.”
Par. (2)(D). , (iii), substituted “Group health plan coverage or medicare eligibility” for “Reemployment or medicare eligibility” as heading and substituted “covered under any other group health plan (as an employee or otherwise)” for “a covered employee under any other group health plan” in cl. (i).
Par. (2)(D)(ii). , inserted “in the case of a qualified beneficiary other than a qualified beneficiary described in ” before “entitled”.
Par. (2)(E). , struck out subpar. (E), remarriage of spouse, which read as follows: “In the case of an individual who is a qualified beneficiary by reason of being the spouse of a covered employee, the date on which the beneficiary remarries and becomes covered under a group health plan.”
## Statutory Notes and Related Subsidiaries
### Effective Date of 2011 Amendment
Amendment by applicable to periods of coverage which would (without regard to the amendments made by ) end on or after the date which is 30 days after , see , set out as a note under , Internal Revenue Code.
### Effective Date of 2010 Amendment
Amendment by applicable to periods of coverage which would (without regard to such amendment) end on or after , see , set out as a note under , Internal Revenue Code.
### Effective Date of 2009 Amendment
Except as otherwise provided and subject to certain applicability provisions, amendment by effective upon the expiration of the 90-day period beginning on , see , set out as an Effective and Termination Dates of 2009 Amendment note under , Customs Duties.
Amendment by applicable to periods of coverage which would (without regard to amendment by ) end on or after , see , set out as a note under , Internal Revenue Code.
### Effective Date of 1996 Amendments
Amendment by effective , regardless of whether qualifying event occurred before, on, or after such date, see set out as a note under , Internal Revenue Code.
Amendment by applicable to plan years beginning after , see , set out as a note under .
### Effective Date of 1989 Amendment
> “The amendments made by this section [amending this section and
>
> ] shall apply to plan years beginning on or after the date of the enactment of this Act [
>
> ], regardless of whether the qualifying event occurred before, on, or after such date.”
, , , provided that:
Amendment by applicable to (i) qualifying events occurring after , and (ii) in the case of qualified beneficiaries who elected continuation coverage after , the period for which the required premium was paid (or was attempted to be paid but was rejected as such), see , set out as a note under , Internal Revenue Code.
Amendment by applicable to plan years beginning after , see , set out as a note under .
Amendment by applicable to plan years beginning after , see , set out as a note under .
### Effective Date of 1986 Amendments
Amendment by effective, except as otherwise provided, as if included in enactment of the Consolidated Omnibus Budget Reconciliation Act of 1985, , see , set out as a note under , Internal Revenue Code.
Amendment by effective, except as otherwise provided, as if included in title X of the Consolidated Omnibus Budget Reconciliation Act of 1985, , see , set out as a note under .
### Plan Amendments Not Required Until January 1, 1989
For provisions directing that if any amendments made by subtitle A or subtitle C of title XI [§§ 1101–1147 and 1171–1177] or title XVIII [§§ 1800–1899A] of require an amendment to any plan, such plan amendment shall not be required to be made before the first plan year beginning on or after , see , set out as a note under , Internal Revenue Code.