Geissal v. Moore Medical Corp., 524 U.S. 74, 13 (1998)

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86

GEISSAL v. MOORE MEDICAL CORP.

Opinion of the Court

the beneficiary's other group health plan.9 See 114 F. 3d, at 1464-1465; accord, National Cos. Health Benefit Plan v. St. Joseph's Hosp., Inc., 929 F. 2d, at 1571; Brock v. Primedica, Inc., 904 F. 2d 295, 297 (CA5 1990). When there is such a gap, some courts have explained, it cannot be said that the employee is truly "covered" by his pre-existing insurance coverage. See 114 F. 3d, at 1463; National Cos. Health Benefit Plan v. St. Joseph's Hosp., Inc., supra, at 1571.

This "significant gap" approach to § 1162(2)(D)(i) is plagued with difficulties, however, beginning with the sheer absence of any statutory support for it. Section 1162(2)(D)(i) makes no mention of what to do when a person's other coverage is generally inadequate or inferior; instead, it provides merely that coverage under a later acquired group health plan will not terminate COBRA rights when that plan limits or excludes coverage for a pre-existing condition of the beneficiary. The proviso applies not when there is a "gap" or difference between the respective coverages of the two policies, but when the later acquired group coverage excludes or limits coverage specific to the beneficiary's pre-existing condition. It is this "gap" between different coverage provisions of the non-COBRA plan, not a gap between the coverage provisions of the COBRA plan and the non-COBRA plan, that Congress was legislating about.

But even leaving textual inadequacy aside, there is further trouble under the "significant gap" approach. Needless to say, when the proviso (as written) arguably does apply, its applicability is easy to determine. Once the beneficiary's pre-existing condition is identified, a court need only look among the terms of the later policy for an exclusion or limita-9 The lower courts have disagreed about whether this "significant gap" interpretation should be made by evaluating the actual expenses an employee incurs as a result of COBRA cancellation, or by comparing the policies' provisions in light of the information available to the employer on the day of the COBRA election. See 114 F. 3d, at 1464-1465 (comparing approaches).

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