Benefits for 2024 Legal Notices
COBRA
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 continuationcoverage, when itmay become available to you and your family, and whatyou 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
thatmay costlessthanCOBRAcontinuationcoverage.
The right to COBRA continuation coverage was created by a federal law, the Consolidated Omnibus Budget Reconciliation Act of1985
(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 SummaryPlan Descriptionorcontactthe Plan Administrator.
You mayhave other options available to you when you lose group health coverage. Forexample, you maybe eligible to buy an
individual plan through the Health Insurance Marketplace. By enrolling in coverage through the Marketplace, you mayqualifyforlower
costson your monthlypremiumsand lower out-of-pocketcosts. 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 that 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 lifeevent. This isalso
calleda “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. Under the Plan, qualifiedbeneficiaries
who elect COBRA continuation coverage mustpay for COBRA continuation coverage.
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 grossmisconduct.
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.
2024 Employee Benefit Guide
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