Benefits for 2025
Tacodeli
Legal Notices
If you’re the spouse of an employee, you’ll become a qualified beneficiary if you lose your coverage under the Plan
because of the following qualifying events:
Your spouse dies;
•
• Your spouse’s hours of employment are reduced;
• Your spouse’s employment ends for any reason other than his or her gross misconduct;
• Your spouse becomes entitled to Medicare benefits (under Part A, Part B, or both); or
• You become divorced or legally separated from your spouse.
Your dependent children will become qualified beneficiaries if they lose coverage under the Plan because of the following
qualifying events:
The parent-employee dies;
•
• The parent- employee’s hours of employment are reduced;
• The parent- employee’s employment ends for any reason other than his or her gross misconduct;
• The parent-employee becomes entitled to Medicare benefits (Part A, Part B, or both);
• The parents become divorced or legally separated; or
• The child stops being eligible for coverage under the Plan as a “dependent child.”
When is COBRA continuation coverage available?
The Plan will offer COBRA continuation coverage to qualified beneficiaries only after the Plan Administrator has been
notified that a qualifying event has occurred. The employer must notify the Plan Administrator of the following qualifying
events:
• The end of employment or reduction of hours of employment;
Death of the employee;
•
• The employee’s becoming entitled to Medicare benefits (under Part A, Part B, or both).
For all other qualifying events (divorce or legal separation of the employee and spouse or a dependent child’s losing
eligibility for coverage as a dependent child), you must notify the Plan Administrator within 60 days [ or enter longer period
permitted under the terms of the Plan ] after the qualifying event occurs. You must provide this notice to: [ Enter name of
appropriate party ].
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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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