Tacodeli - 2025 Benefit Guide (English)

Legal Notices Benefits for 2025

Tacodeli

Model General Notice of COBRA Continuation Coverage Rights (For use by single-employer group health plans)

** Continuation Coverage Rights Under COBRA**

Introduction

You’re getting this notice because you recently gained coverage under a group health plan (the Plan). This notice has

important information about your right to COBRA continuation coverage, which is a temporary extension of coverage under

the Plan. This notice explains COBRA continuation coverage, when it may become available to you and your family, and

what you need to do to protect your right to get it. When you become eligible for COBRA, you may also become eligible for

other coverage options that may cost less than COBRA continuation coverage.

The right to COBRA continuation coverage was created by a federal law, the Consolidated Omnibus Budget Reconciliation

Act of 1985 (COBRA). COBRA continuation coverage can become available to you and other members of your family

when group health coverage would otherwise end. For more information about your rights and obligations under the Plan

and under federal law, you should review the Plan’s Summary Plan Description or contact the Plan Administrator.

You may have other options available to you when you lose group health coverage. For example, you may be eligible to

buy an individual plan through the Health Insurance Marketplace. By enrolling in coverage through the Marketplace, you

may qualify for lower costs on your monthly premiums and lower out-of-pocket costs. Additionally, you may qualify for a 30-

day special enrollment period for another group health plan for which you are eligible (such as a spouse’s plan), even if tha t

plan generally doesn’t accept late enrollees.

What is COBRA continuation coverage?

COBRA continuation coverage is a continuation of Plan coverage when it would otherwise end because of a life event. This

is also called a “qualifying event.” Specific qualifying events are listed later in this notice. After a qualifying event, COBRA

continuation coverage must be offered to each person who is a “qualified beneficiary.” You, your spouse, and your

dependent children could become qualified beneficiaries if coverage under the Plan is lost because of the qualifying event

If you’re an employee, you’ll become a qualified beneficiary if you lose your coverage under the Plan because of the

following qualifying events:

• Your hours of employment are reduced, or

• Your employment ends for any reason other than your gross misconduct.

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This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations, and exclusions set forth in each insurance carrier or provider’s contract.

2025 Employee Benefit Guide

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