qualified beneficiary

(1) Qualified beneficiary (A) In general The term “qualified beneficiary” means, with respect to a covered employee under a group health plan, any other individual who, on the day before the qualifying event for that employee, is a beneficiary under the plan— (i) as the spouse of the covered employee, or (ii) as the dependent child of the employee. Such term shall also include a child who is born to or placed for adoption with the covered employee during the period of continuation coverage under this section. (B) Special rule for terminations and reduced employment In the case of a qualifying event described in subsection (f)(3)(B), the term “qualified beneficiary” includes the covered employee. (C) Exception for nonresident aliens Notwithstanding subparagraphs (A) and (B), the term “qualified beneficiary” does not include an individual whose status as a covered employee is attributable to a period in which such individual was a nonresident alien who received no earned income (within the meaning of section 911(d)(2)) from the employer which constituted income from sources within the United States (within the meaning of section 861(a)(3)). If an individual is not a qualified beneficiary pursuant to the previous sentence, a spouse or dependent child of such individual shall not be considered a qualified beneficiary by virtue of the relationship of the individual. (D) Special rule for retirees and widows In the case of a qualifying event described in subsection (f)(3)(F), the term “qualified beneficiary” includes a covered employee who had retired on or before the date of substantial elimination of coverage and any other individual who, on the day before such qualifying event, is a beneficiary under the plan— (i) as the spouse of the covered employee, (ii) as the dependent child of the covered employee, or (iii) as the surviving spouse of the covered employee.

Source

26 USC § 4980B(g)(1)


Scoping language

For purposes of this section
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