Who Is Considered a Qualified Beneficiary (also known as "QB")?

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  3. Definition: Qualified Beneficiary

In health insurance terminology, “QB” stands for Qualified Beneficiary. A Qualified Beneficiary is an individual who meets specific criteria outlined by COBRA regulations, making them eligible for continued coverage under a group health plan. These criteria typically include employees, their spouses, and dependent children who were covered by the employer’s health insurance plan before experiencing a qualifying event, such as job loss or a reduction in work hours.

Qualified Beneficiaries can include:

  1. Employees who lose their jobs or have their work hours reduced, resulting in the loss of employer-sponsored health insurance coverage.
  2. Spouses of employees who were covered under the employer's health insurance plan.
  3. Dependent children who were covered under the employer's health insurance plan.

Eligibility Criteria for Qualified Beneficiaries

To qualify as a Qualified Beneficiary under COBRA, individuals must meet specific eligibility criteria, including:
  1. Being covered under the employer's group health plan at the time of a qualifying event.
  2. Experiencing a qualifying event that results in the loss of health insurance coverage, such as termination of employment, reduction in work hours, or certain life events like divorce or legal separation.
  3. Not being eligible for Medicare at the time of the qualifying event.
  4. Timely electing COBRA continuation coverage within the specified enrollment period.