| |
|
COBRA
Consolidated Omnibus Reconciliation Act of 1985 |
|
In addition to the Company’s continuation of coverage provision,
employees and/or dependents may be entitled to continue healthcare at
their own expense under COBRA |
|
Qualifying Events |
|
EMPLOYEES |
| |
Ø |
Termination of employment (for any reason other than gross misconduct) |
|
|
Ø |
Reduction in the hours of employment |
|
SPOUSES AND DEPENDENTS |
| |
Ø |
Employee’s termination of employment (other than gross misconduct) |
| |
Ø |
Employee’s reduction in the number of hours of employment |
| |
Ø |
Covered employee becoming entitled to Medicare |
| |
Ø |
Divorce or legal separation |
| |
Ø |
Death of the covered employee |
| |
Ø |
Loss of dependent status as defined in the Company’s group healthcare
plans |
|
Notification Requirements |
|
The employee, spouse, or dependent child MUST notify the Company (NESC)
within 60 days of the qualifying event if the event is: |
| |
w |
Divorce |
| |
w |
Dependent child’s loss of dependent status |
| |
w |
Death of the employee if it results in loss of coverage |
|
For “other” Qualifying Events: |
| |
w |
The Company will notify the COBRA Coordinator (presently UniCare). |
| |
w |
UniCare will send additional information to individuals eligible to
elect COBRA. |
| |
w |
If the employee or dependent elects to continue coverage under COBRA,
they must return an election form to UniCare within 60 days of receipt
of such form. |
|
Duration of COBRA Coverage |
| |
Up to 18 months for covered employees, their spouses and dependents
|
| |
ð |
When coverage is lost as a result of a termination or reduction in hours |
| |
Up to 29 months for COBRA beneficiaries
|
| |
|
Applies to beneficiaries who are disabled at the time of the qualifying
event or within 60 days of COBRA coverage |
| |
Up to 36 months for spouses and dependents |
| |
ð |
Applies if facing a loss of employer-provided coverage due to an
employee’s death, divorce or legal separation |
|
COBRA COVERAGE'S |
| |
If eligible to continue coverage, it will be the same coverage the
member was eligible for before the qualifying event |
| |
Example:
If the member and dependents were enrolled in traditional medical
and dental, they would be offered the same coverage if they elect to
continue benefits under COBRA. |
|
COBRA COSTS |
| |
COBRA is 102% of the full group rate in effect at the time continued
coverage begins. |
| |
Exception:
If the member is disabled at the time of the termination, they are
eligible for COBRA for 29 months rather than 18 months but the cost for
the additional 11 months is 150% of the regular full group rate rather
than the normal 102%. |
|
Termination of COBRA |
|
Coverage under COBRA will be terminated before the end of the 18, 29 or
36 month period for any of the following reasons: |
| |
ð |
Failure to make required monthly payments |
| |
ð |
Voluntary cancellation of coverage |
| |
ð |
The Company no longer provides group health care coverage to any of its
employees or retirees |
|
Contact Information |
|
Notify the NESC within 60 days of the Qualifying Event @
1-800-248-4444 |
|
Inquiries regarding COBRA eligibility, information or election
forms, call UniCare @
1-800-843-8184 (ask for COBRA unit)
|
