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John, Employment Lawyer
Category: Employment Law
Satisfied Customers: 5626
Experience:  Exclusively practice labor and employment law.
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I am getting ready to leave my current job. I am needing to

Customer Question

I am getting ready to leave my current job. I am needing to go on COBRA for one month. The way my company has the health insurance set up is that we pay separately for prescription drugs. Thus, health and prescriptions are two different policies. I was told that prescription drugs are not covered under COBRA. That will hurt me as I have Type 1 diabetes. One month will hurt without prescription drug coverage. I read a legal site that said that through COBRA, the same health benefits the company offers must be made available through COBRA. I am willing to pay for it as I understand COBRA is my responsibility. My question to you is it legal for a company NOT to include prescription drugs under COBRA?
Submitted: 1 year ago.
Category: Employment Law
Expert:  John replied 1 year ago.

Your question is somewhat of trick question - clearly prescription plans are covered by COBRA - that's indisputable. But the meat of your question is in the details - namely is the prescription plan really a group health plan as defined by the law, which would in turn make it subject to COBRA. The test is whether a reasonable person could ascertain from the surrounding circumstances: (1) intended benefits, (2) intended beneficiaries, (3) a source of financing, and (4) a procedure for obtaining benefits. If the plan involves no contribution by the employer, participation by the employee is voluntary, and there is no endorsement by the employer (i.e., they just let you join the plan - they do bot advocate for it), then the plan is not a COBRA-eligible plan. Otherwise, it is a COBRA-covered health plan plan, and you must be allowed to participate at up to 102% of the cost of the plan.

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