Employees Plan Continuation Rights And Options Under COBRA
After your employees enroll in our health and dental plans, we will send them information explaining their continuation rights and options. An individual is entitled to continuation coverage if he or she is a qualified beneficiary who experiences a qualifying event.
A qualified beneficiary can be an employee, spouse, or dependent(s) who is covered under the employer’s group plan on the day before a qualifying event takes place. The only exception to this rule is a child who is born to, or placed for adoption with, a qualified beneficiary who was previously the covered employee during the COBRA continuation period also becomes a qualified beneficiary.
Note: If your policy covers domestic partners, the Trust extends continuation coverage to domestic partners and their biological or legally adopted children who were covered under the group plan on the day before a qualifying event took place.
A qualifying event is any of the following which causes a qualified beneficiary to lose his or her coverage under the employer’s group plan:
- Death of the covered employee.
- Termination of the covered employee’s employment.
- Reduction in the covered employee’s hours.
- Divorce or annulment of the covered employee’s marriage.
- Covered employee’s eligibility for Medicare benefits.
- Loss of a dependent child’s eligibility for coverage under the plan.
Duration of coverage
Qualified beneficiaries are eligible to continue group coverage for 18 months for qualifying events due to employment termination or reduction in work hours. Other 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. In addition, special rules for disabled individuals may also extend the maximum period of coverage from 18 months to 29 months.
Please refer to the Notice of Your Continuation Coverage Rights Under COBRA form for a further explanation of second qualifying events and the rights of disabled individuals.
Survivors of employees who die at age 55 or older may continue group health coverage for as long as desired (even if they remarry or obtain other group coverage), provided we receive the required premiums and continue to insure the eligible class to which the employee belonged.
* Applies only to groups with Continuation Coverage for Surviving Dependents Benefit.
Employees who retire at age 55 or older may continue group health coverage for as long as desired (even if they obtain other group coverage), as long as we receive the required premiums and continue to insure the eligible class of employees to which the employee belonged before retirement.
** Applies only to groups with Retiree Continuation Benefit.
Notice of Continuation Coverage Under COBRA