Which plans are subject to federal COBRA?

• A. All employer plans regardless of size.
• B. Group health plans sponsored by private-sector employers with 20 or more employees and certain government plans that elect COBRA; both insured and self-insured plans are covered.
• C. Only group health plans that are fully insured are subject to COBRA.
• D. Group health plans sponsored by private-sector employers with 20 or more employees and certain government plans that elect COBRA; only insured plans are covered.

Answer: (B)

COBRA applies to group health plans that are maintained by private-sector employers with 20 or more employees, and to certain government plans that elect COBRA to offer continuation coverage. A key point is that COBRA covers both insured and self-insured group plans, not just one funding type. This means that if a private-sector employer has 20+ employees, their group health plan—whether it is fully insured or self-insured—must offer COBRA continuation to eligible individuals. In addition, some government plans may elect COBRA to provide continuation coverage as well.

The other options are off because they either overstate or misstate the scope. COBRA does not automatically apply to all employer plans regardless of size; the federal rule typically covers private-sector employers with 20+ employees (small employers can be covered by state mini-COBRA laws, but not by federal COBRA). It also does not limit COBRA to insured plans—self-insured plans are included as well. And it does not require government plans to be insured, only that eligible government plans elect COBRA. The described option matches these criteria, making it the best choice.