COBRA

When COBRA Coverage is 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. When the qualifying event is the end of employment or reduction of hours of employment, or the death of the employee, you need not notify the Plan Administrator of these qualifying events.

Notice of Qualifying Events

For the 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 in writing within 60 days after the qualifying event occurs. You must provide this notice to the Plan Administrator at the address provided at the end of this notice. Your notice must include your name, the covered employee's name (if you are covered as a spouse or dependent), your current address and telephone number, a description of the qualifying event, the date of the event and, in the case of divorce, a copy of the divorce decree. No COBRA election will be available unless you follow the Plan's notice procedures and meet the notice deadline.

2016 COBRA Rates

Who is Entitled to Elect COBRA?

If you are covered under the Plan as an employee, you will become a qualified beneficiary if you lose your coverage under the Plan because either one of the following qualifying events happens:

  • Your hours of employment are reduced
  • Your employment ends for any reason other than your gross misconduct

If you are covered under the Plan as the spouse of an employee, you will become a qualified beneficiary if you lose your coverage under the Plan because any of the following qualifying events happens:

  • 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
  • You become divorced or legally separated from your spouse

Your dependent children that are covered under the Plan will become qualified beneficiaries if they lose coverage under the Plan because any of the following qualifying events happens:

  • The parent-employee dies
  • The parent-employee's hours of employment are reduced
  • The employee's employment ends for any reason other than his or her gross misconduct
  • The child stops being eligible for coverage under the plan as a "dependent child"

How COBRA Coverage is Provided

Once the Plan Administrator receives notice that a qualifying event has occurred, COBRA continuation coverage will be offered to each of the qualified beneficiaries. Each qualified beneficiary will have an independent right to elect COBRA continuation coverage. Covered employees may elect COBRA continuation coverage on behalf of their spouses, and parents may elect COBRA continuation coverage on behalf of their children. 

Click here to print Continuation Coverage Rights Under COBRA.