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WASHINGTON-The Internal Revenue Service is offering new guidance on the premiums that employers can charge employees' spouses and dependents who opt for COBRA coverage in certain situations.
The IRS guidance deals with situations in which spouses and dependents opt for COBRA coverage but the employee does not, and whether under such a scenario the spouses or dependents pay 102% of the individual rate or 102% of the family rate to receive COBRA coverage.
Such a situation could occur, for example, when an employee with a family loses his job. The entire family would be eligible for COBRA coverage. Later, though, the employee divorces the spouse and receives health care coverage through his new employer. The issue-which is addressed by the IRS in a question-and-answer format-is how much COBRA premium should then be paid by the spouse and other dependents.
Under the example provided by the IRS, the employer's health insurance costs are $150 per month for individual coverage and $400 per month for family coverage.
An event occurs in which the employee and his spouse are eligible for COBRA coverage. Only the spouse, though, opts for COBRA coverage.
In that situation, the IRS says, the employer can only charge the spouse a COBRA premium equal to 102% of the individual rate of $150 a month.
As an individual, the spouse is a "sole qualified beneficiary" and "is not similarly situated to the family category of beneficiaries, which includes only groups of two or more individuals," the IRS said.
In the other situation addressed by the IRS, the employee and spouse have one dependent child. If COBRA continuation coverage is elected only for the child, the employer again only could charge a COBRA premium equal to 102% of the individual rate.
However, if both the spouse and the dependent child both opted for COBRA coverage, the employer could charge a COBRA premium equal to 102% of the family rate. That is because, according to the IRS, "these two qualified beneficiaries are members of the same family and they are similarly situated to the category of two or more beneficiaries from the same family."
While the answers offered by the IRS appear obvious, the IRS issued the guidance on COBRA premiums because it apparently felt there was some uncertainty among employers in this area, explained Henry Saveth, a principal with A. Foster Higgins & Co. Inc. in New York.
The IRS guidance-formally known as Revenue Ruling 96-8-will be published later this month in the Internal Revenue Bulletin 1996-4.