IMPORTANT NOTICE TO ELIGIBLE PARTICIPANTS ON CONTINUATION OF COVERAGE LAW (COBRA)

Federal law requires most Group Health Benefit Plans to offer employees and their families the opportunity for a temporary extension of health coverage called “continuation coverage” at group rates in certain instances where the person’s eligibility for coverage under the Plan would otherwise end.

This notice is intended to inform You, in summary fashion, of Your rights and obligations under the continuation coverage provision of the law. You may also be entitled to access to the State Exchanges as provided pursuant to the Patient Protection and Affordable Care Act.

  1. Eligible Plan Participants will have the right to choose continuation coverage if he loses his health coverage because his eligibility is terminated.
  2. The lawful spouse of a Plan Participant will also have the right to choose continuation coverage if the spouse loses his health coverage for any of the following reasons:
    1. The death of the Plan Participant; or
    2. The termination of the Plan Participant’s eligibility under the Plan; or
    3. The termination of the spouse’s eligibility under the Plan by reason of divorce or legal separation from the Plan Participant: or
    4. The Plan Participant becomes covered by Medicare.
  3. In the case of a Dependent child of an eligible Plan Participant, he has the right to choose continuation coverage if the Dependent child loses his health coverage for any of the following reasons:
    1. The death of the Plan Participant; or
    2. The termination of the Plan Participant’s eligibility under the Plan; or
    3. Parents divorce or legal separation; or
    4. The Plan Participant becomes covered by Medicare; or
    5. The child ceases to be a “Dependent Child” under the Plan.

Under the law, the Plan Participant is directly responsible for promptly notifying the Fund Office of a divorce, legal separation, or a child losing Dependent status under this Benefit Plan. We will in turn notify the person that he has the right to choose continuation coverage.

The law requires that You be afforded the opportunity to pay all the contribution costs to maintain continuation coverage for 36 months unless the Plan Participant lost his health coverage because of a termination of employment and/or failure to work the required hours to maintain eligibility. In that case, the required continuation coverage period is 18 months. Coverage may be maintained for up to 29 months if the Plan Participant is disabled under Title II or XVI of the Social Security Act at the time employment ended or his work hours were reduced or he became disabled at any time during his COBRA continuation coverage. In the case of a dependent child whose coverage has been terminated due to the plan age limit eligibility rules, the Trustees have authorized an  additional 24 months over and above the required 36 months, to a maximum of 60 months of continuation coverage. However, the law also provides that Your continuation coverage may be cut short for any of the following reasons:

  1. The contribution required for continuation coverage is not paid as due; or
  2. You become an employee or are otherwise covered under another group health plan, if that plan does not include any pre-existing limitations or exclusions with respect to You; or
  3. You become covered by Medicare; or
  4. You were divorced from a Plan Participant and subsequently remarry and are covered under Your new spouse’s group health plan.

If You have any questions about this law, contact the Fund Office.