Policy/Memo 65r6

Number: Policy Memo 65r6
Date Issued: October 30, 1992
Date Revised: June 3, 2026
Subject: COBRA Termination due to Medicare Entitlement

PURPOSE:

Determine when an enrollee or covered dependent’s COBRA coverage through NYSHIP should be terminated due to Medicare entitlement.

BACKGROUND:

In accordance with Section 54.4980B-7 of Title 26 Code of Federal Regulations, employers are permitted to terminate COBRA coverage for an enrollee or covered dependent who becomes entitled to Medicare benefits after they enroll in COBRA coverage. The following policy addresses the procedure for enrollees and covered dependents who enroll in COBRA coverage and then become entitled to Medicare.

POLICY:

EBD shall terminate NYSHIP COBRA medical coverage for an enrollee or covered dependent when they become entitled to Medicare after the date of COBRA election. If family coverage is in effect, COBRA coverage for the remaining eligible persons will continue until the end of the COBRA period or when they otherwise lose eligibility (for example, a dependent child turning age 26). As of the publication of this memo revision, EBD will no longer terminate NYSHIP COBRA dental and/or vision for a NYS or PE enrollee or covered dependent when they become entitled to Medicare after the date of COBRA election.

In most cases, an enrollee or covered dependent becomes eligible for Medicare benefits when reaching age 65. Alternatively, eligibility for Medicare will be established when an enrollee or covered dependent receives Social Security Disability Insurance (SSDI) benefits for 24 months or when receiving SSDI benefits due to Amyotrophic Lateral Sclerosis (ALS). In any case, EBD will terminate COBRA medical coverage on the date the enrollee or covered dependent is first eligible for Medicare.