LLEEGGAALL NNOOTTI ICCEESS
COBRA
How is COBRA continuation coverage provided? Once the Plan Administratorreceives notice that a qualifying event has occurred,COBRA continuation coverage will be offered to each of the qualified beneficiaries. Each qualified beneficiary will have an independent right to elect COBRA continuation coverage. Covered employees mayelect COBRA continuation coverage on behalf of their spouses, and parents mayelect COBRA continuation coverage on behalf of their children. COBRA continuation coverage is a temporary continuation of coverage that generally lastsfor 18 monthsdue to employment terminationor reduction of hours of work. Certain qualifying events, or a second qualifying event during the initial period of coverage, may permit a beneficiary to receive a maximum of 36 months of coverage.
There are also ways in which this 18-month period of COBRA continuation coverage can be extended:
Disability extensionof 18-month period of COBRAcontinuationcoverage If you or anyone in your familycovered under the Plan is determined by SocialSecurityto be disabled and you notifythe Plan Administrator in a timely fashion, you and your entire family may be entitled to get up to an additional 11 months of COBRA continuation coverage, for a maximumof 29 months. The disabilitywould have to have startedat sometimebefore the 60th day of COBRAcontinuation coverage and mustlast at least untilthe end of the 18-month period of COBRA continuation coverage. Second qualifying event extensionof 18-month period ofcontinuationcoverage If your familyexperiences another qualifyingevent during the 18 months of COBRA continuation coverage, the spouse and dependent childrenin your familycan get up to 18 additional months of COBRAcontinuation coverage, fora maximumof 36 months,if the Plan is properlynotified about the secondqualifyingevent. This extension maybe available to the spouse and any dependent childrengetting COBRA continuation coverage if the employee or formeremployee dies; becomesentitled to Medicare benefits (under Part A, Part B, or both); gets divorced or legally separated; or if the dependent child stops being eligible under the Plan as a dependent child. Thisextension is only available if the secondqualifying event would have causedthe spouseor dependent child to lose coverage under the Plan had the firstqualifyingevent not occurred. Are there other coverage optionsbesides COBRAContinuationCoverage? Yes. Instead of enrolling in COBRA continuation coverage, there may be other coverage options for you and your family through the Health Insurance Marketplace, Medicare, Medicaid, Children’s Health Insurance Program (CHIP), or other group health plan coverage options (such as a spouse’s plan) through what is called a “special enrollment period.” Some of these options may cost less than COBRA continuation coverage. You can learn more about many of these options at www.healthcare.gov . Can I enroll in Medicare instead of COBRAcontinuationcoverage after my grouphealth plan coverage ends? In general, if you don’t enroll in Medicare Part A or B when you are first eligible because you are still employed, after the Medicare initial enrollmentperiod, you have an 8-month special enrollmentperiod 1 to sign up for Medicare Part A or B, beginning on the earlier of • The month after your employment ends; or • The month aftergroup health plan coverage based on current employmentends. If you don’t enroll in Medicare and elect COBRA continuation coverage instead, you may have to pay a Part B late enrollment penalty and you mayhave a gap in coverage if you decide you want Part B later. If you elect COBRA continuation coverage and later enroll in Medicare Part A or B before the COBRA continuation coverage ends, the Plan mayterminateyour continuation coverage. However, if Medicare Part A or B is effective on or before the date of the COBRA election, COBRA coverage may not be discontinued on account of Medicare entitlement, even if you enrollin the other part of Medicareafterthe date of the election of COBRAcoverage.
If you are enrolled in both COBRA continuation coverage and Medicare, Medicare willgenerally pay first (primarypayer) and COBRA continuation coverage willpay second. Certainplans maypay as if secondaryto Medicare, even if you are not enrolled in Medicare.
For more information visit https://www.medicare.gov/medicare-and-you.
BENEFITS GUIDE
LEGAL NOTICES - COBRA I
46
Made with FlippingBook - Online catalogs