
COBRA Continuation Coverage is subject to the terms of
your current medical/dental plan and the federal Consolidated Omnibus Budge
Reconciliation Act of 1985 (COBRA.)
ELIGIBILITY
If you have been covered by
the Plan on the day before a qualifying event, you may be eligible for COBRA Continuation Coverage.
The following are qualifying events for such Coverage:
Subscriber's loss of coverage because of:
Covered Dependents loss of coverage because of:
ENROLLING FOR COBRA CONTINUATION COVERAGE
The administrator, acting on behalf of the Employer, shall
notify you of your rights to enroll for COBRA Continuation Coverage after:
You have 60 days from the later of the date of the qualifying event or the date that you receive notice of the right to COBRA Continuation Coverage to enroll for such coverage. The Employer or the administrator will send the forms that should be used to enroll for COBRA Continuation Coverage. If you do not send the enrollment form to the Employer within that 60-day period, you will lose your right to COBRA Continuation Coverage under this Plan. If you are qualified for COBRA Continuation Coverage and receive services that would be covered services before enrolling and submitting the payment for such coverage, you will be required to pay for those services. The Plan will reimburse you for covered services, less required member payments, after you enroll and submit the payment for coverage, and submit a claim for those covered services as set forth in this Plan.
PAYMENT
You must submit any payment
required for COBRA Continuation Coverage to the administrator at the address
indicated on your payment notice. If you do not enroll when first becoming
eligible, the payment due for the period between the date you first become
eligible and the date you enroll for COBRA Continuation Coverage must be paid to
the Employer (or to the administrator, if so directed by the Employer)
within 45 days after the date you enroll for COBRA Continuation Coverage.
After enrolling for COBRA Continuation Coverage, all payments are due and
payable on a monthly basis as required by the Employer. If the payment is
not received by the administrator on or before the due date, coverage will be
terminated, for cause, effective as of the last
day for which payment was received as explained in the Plan. The
administrator may use a third party vendor to collect the COBRA payment.
COVERAGE PROVIDED
If you enroll for
COBRA Continuation Coverage you will continue to be covered under the
Plan. The COBRA Continuation Coverage is subject to the conditions,
limitations and exclusions of the Plan and the EOC. The Plan and the
Employer may agree to change the ASA and/or the EOB. The Employer may also
decide to change administrators. If this happens after you enroll
for COBRA Continuation Coverage, your coverage will be subject so such changes.
DURATION OF ELIGIBILITY FOR COBRA CONTINUATION COVERAGE
COBRA Continuation Coverage is available for a maximum
of:
TERMINATION OF COBRA CONTINUATION COVERAGE
After you have elected COBRA Continuation Coverage, that
coverage will terminate either at the end of the applicable 18, 29 or 36 month
eligibility period or, before the end of that period, upon the date
that:
Monday, Wednesday, and Friday, 8:00 a.m. to 4:00 p.m.
Tuesday & Thursday, 7:00 a.m. to 4:00 p.m.
The Employment Office is located in the Human Resources department at the corner of Third Street & Hampton Street.