[Code of Federal Regulations]
[Title 29, Volume 9]
[Revised as of July 1, 2004]
From the U.S. Government Printing Office via GPO Access
[CITE: 29CFR2590.606-3.]

[Page 614-616]
 
                             TITLE 29--LABOR
 
 CHAPTER XXV--EMPLOYEE BENEFITS SECURITY ADMINISTRATION, DEPARTMENT OF 
                                  LABOR
 
PART 2590_RULES AND REGULATIONS FOR GROUP HEALTH PLANS--Table of Contents
 
Subpart A_Continuation Coverage, Qualified Medical Child Support Orders, 
                      Coverage for Adopted Children
 
Sec. 2590.606-3.  Notice requirements for covered employees and qualified 
beneficiaries.

    (a) General. In accordance with the authority of sections 505 and 
606(a)(3) of the Employee Retirement Income Security Act of 1974, as 
amended (the Act), this section sets forth requirements for group health 
plans subject to the continuation coverage requirements of part 6 of 
title I of the Act with respect to the responsibility of covered 
employees and qualified beneficiaries to provide the following notices 
to administrators:
    (1) Notice of the occurrence of a qualifying event that is a divorce 
or legal separation of a covered employee from his or her spouse;
    (2) Notice of the occurrence of a qualifying event that is a 
beneficiary's ceasing to be covered under a plan as a dependent child of 
a participant;
    (3) Notice of the occurrence of a second qualifying event after a 
qualified beneficiary has become entitled to continuation coverage with 
a maximum duration of 18 (or 29) months;
    (4) Notice that a qualified beneficiary entitled to receive 
continuation coverage with a maximum duration of 18 months has been 
determined by the Social Security Administration, under title II or XVI 
of the Social Security Act (42 U.S.C. 401 et seq. or 1381 et seq.) 
(SSA), to be disabled at any time during the first 60 days of 
continuation coverage; and
    (5) Notice that a qualified beneficiary, with respect to whom a 
notice described in paragraph (a)(4) of this section has been provided, 
has subsequently been determined by the Social Security Administration, 
under title II or XVI of the SSA to no longer be disabled.
    (b) Reasonable procedures. (1) A plan subject to the continuation 
coverage requirements shall establish reasonable procedures for the 
furnishing of the notices described in paragraph (a) of this section.
    (2) For purposes of this section, a plan's notice procedures shall 
be deemed reasonable only if such procedures:
    (i) Are described in the plan's summary plan description required by 
Sec. 2520.102-3 of this chapter;
    (ii) Specify the individual or entity designated to receive such 
notices;
    (iii) Specify the means by which notice may be given;
    (iv) Describe the information concerning the qualifying event or 
determination of disability that the plan deems necessary in order to 
provide continuation coverage rights consistent with the requirements of 
the Act; and
    (v) Comply with the requirements of paragraphs (c), (d), and (e) of 
this section.
    (3) A plan's procedures will not fail to be reasonable, pursuant to 
this section, solely because the procedures require a covered employee 
or qualified beneficiary to utilize a specific form to provide notice to 
the administrator, provided that any such form is easily available, 
without cost, to covered employees and qualified beneficiaries.
    (4) If a plan has not established reasonable procedures for 
providing a notice required by this section, such notice shall be deemed 
to have been provided when a written or oral communication identifying a 
specific event is made in a manner reasonably calculated to bring the 
information to the attention of any of the following:
    (i) In the case of a single-employer plan, the person or 
organizational unit that customarily handles employee benefits matters 
of the employer;
    (ii) In the case of a plan to which more than one unaffiliated 
employer contributes, or which is established or maintained by an 
employee organization, either the joint board, association, committee, 
or other similar group (or any member of any such group) administering 
the plan, or the person or organizational unit to which claims for 
benefits under the plan customarily are referred; or
    (iii) In the case of a plan the benefits of which are provided or 
administered by an insurance company, insurance service, or other 
similar organization subject to regulation under the insurance laws of 
one or more States, the person or organizational unit that customarily 
handles claims for benefits under the plan or any officer of the 
insurance company, insurance service, or other similar organization.

[[Page 615]]

    (c) Periods of time for providing notice. A plan may establish a 
reasonable period of time for furnishing any of the notices described in 
paragraph (a) of this section, provided that any time limit imposed by 
the plan with respect to a particular notice may not be shorter than the 
time limit described in this paragraph (c) with respect to that notice.
    (1) Time limits for notices of qualifying events. The period of time 
for furnishing a notice described in paragraph (a)(1), (2), or (3) of 
this section may not end before the date that is 60 days after the 
latest of:
    (i) The date on which the relevant qualifying event occurs;
    (ii) The date on which the qualified beneficiary loses (or would 
lose) coverage under the plan as a result of the qualifying event; or
    (iii) The date on which the qualified beneficiary is informed, 
through the furnishing of the plan's summary plan description or the 
notice described in Sec. 2590.606-1, of both the responsibility to 
provide the notice and the plan's procedures for providing such notice 
to the administrator.
    (2) Time limits for notice of disability determination. (i) Subject 
to paragraph (c)(2)(ii) of this section, the period of time for 
furnishing the notice described in paragraph (a)(4) of this section may 
not end before the date that is 60 days after the latest of:
    (A) The date of the disability determination by the Social Security 
Administration;
    (B) The date on which a qualifying event occurs;
    (C) The date on which the qualified beneficiary loses (or would 
lose) coverage under the plan as a result of the qualifying event; or
    (D) The date on which the qualified beneficiary is informed, through 
the furnishing of the summary plan description or the notice described 
in Sec. 2590.606-1, of both the responsibility to provide the notice 
and the plan's procedures for providing such notice to the 
administrator.
    (ii) Notwithstanding paragraph (c)(2)(i) of this section, a plan may 
require the notice described in paragraph (a)(4) of this section to be 
furnished before the end of the first 18 months of continuation 
coverage.
    (3) Time limits for notice of change in disability status. The 
period of time for furnishing the notice described in paragraph (a)(5) 
of this section may not end before the date that is 30 days after the 
later of:
    (i) The date of the final determination by the Social Security 
Administration, under title II or XVI of the SSA, that the qualified 
beneficiary is no longer disabled; or
    (ii) The date on which the qualified beneficiary is informed, 
through the furnishing of the plan's summary plan description or the 
notice described in Sec. 2590.606-1, of both the responsibility to 
provide the notice and the plan's procedures for providing such notice 
to the administrator.
    (d) Required contents of notice. (1) A plan may establish reasonable 
requirements for the content of any notice described in this section, 
provided that a plan may not deem a notice to have been provided 
untimely if such notice, although not containing all of the information 
required by the plan, is provided within the time limit established 
under the plan in conformity with paragraph (c) of this section, and the 
administrator is able to determine from such notice the plan, the 
covered employee and qualified beneficiary(ies), the qualifying event or 
disability, and the date on which the qualifying event (if any) 
occurred.
    (2) An administrator may require a notice that does not contain all 
of the information required by the plan to be supplemented with the 
additional information necessary to meet the plan's reasonable content 
requirements for such notice in order for the notice to be deemed to 
have been provided in accordance with this section.
    (e) Who may provide notice. With respect to each of the notice 
requirements of this section, any individual who is either the covered 
employee, a qualified beneficiary with respect to the qualifying event, 
or any representative acting on behalf of the covered employee or 
qualified beneficiary may provide the notice, and the provision of 
notice by one individual shall satisfy any responsibility to provide 
notice on

[[Page 616]]

behalf of all related qualified beneficiaries with respect to the 
qualifying event.
    (f) Plan provisions. To the extent that a plan provides a covered 
employee or qualified beneficiary a period of time longer than that 
specified in this section to provide notice to the administrator, the 
terms of the plan shall govern the time frame for such notice.
    (g) Additional rights to continuation coverage. Nothing in this 
section shall be construed to preclude a plan from providing, in 
accordance with its terms, continuation coverage to a qualified 
beneficiary although a notice requirement of this section was not 
satisfied.
    (h) Applicability. This section shall apply to any notice obligation 
described in this section that arises on or after the first day of the 
first plan year beginning on or after November 26, 2004.

[69 FR 30097, May 26, 2004]

    Effective Date Note: At 69 FR 30097, May 26, 2004, subpart A was 
amended by adding Sec. Sec. 2590.606-1 through 2590.606-4, effective 
July 26, 2004.