Under the safe harbor hardship rules, expenses for medical care described in 213(d) are an approved reason for hardship. When I look at 213(d)(1)(D), it states the medical care is for insurance covering medical care referred to in subparagraph (A) and (B). (A) states that medical care is an amount paid for the diagnosis, cure, mitigation, treatment, or prevention of disease, or for the purpose of affecting any structure or function of the body.


Situation : Participant is out on medical leave for at least a year. She wants to take a hardship to pay for COBRA premiums for the next 14 months. Do COBRA premiums meet the safe harbor definition of medical care, and can you approve a request for payment for 14 months in advance??

Thanks!

I would agree that COBRA continuation coverage costs meet the conditions of Section 213(d). As far as the hardship request goes, it is assumed that all other financial sources have been reasonably relieved. To request for a period of 14 month of payments, can someone other than the employee (insurer or doctor) validate the duration of the sick leave? If I were the plan sponsor, I would be concerned about the "amount necessary to satisfy the financial need" language.