COBRA Continuation Coverage

COBRA might be described as the deus ex machina in your benefits story. If you lose eligibility and your coverage ends, COBRA may come to the rescue. "COBRA" stands for the Consolidated Omnibus Budget Reconciliation Act of 1985. By law, if you and your dependents have health care coverage through the Fund and that coverage ends due to certain qualifying events, you may elect to continue your coverage for a specified time, depending on the reason you lose coverage. You're required to pay the full cost of coverage, plus an administrative fee of 2%, for continued medical (including vision) and dental coverage for you and any eligible dependents you wish to cover when you lose eligibility for employer-paid coverage. The Administrative Office is responsible for administering COBRA continuation coverage. All notices regarding COBRA continuation coverage should be sent to the Administrative Office.

To continue coverage, you must pay the premium on a monthly basis. When you first enroll, you may choose a different plan under COBRA than the one in which you were enrolled when you lost eligibility; but once enrolled in your COBRA plan, you may change your plan selection only during an Open Enrollment period or following a change in status.

Who's Eligible For COBRA
COBRA continuation coverage is available to the following qualified beneficiaries:

• Dependents other than same-sex domestic partners who were covered under the Fund's health plans before loss of coverage due to a qualifying event as described below; and
• A child who is born to, adopted by or placed for adoption with you (the writer) while you're covered under COBRA. You must notify the Administrative Office within 30 days of the birth, adoption or placement for adoption. If you don't, the child will lose the right to be covered under COBRA.

If you continue your own coverage under COBRA, you may also cover your same-sex domestic partner as your dependent if you pay the required premiums. However, your partner will have no individual COBRA rights under this coverage.

Qualifying Event
The following chart shows who is eligible for COBRA continuation coverage, under what circumstances - known as qualifying events - and how long COBRA continuation coverage continues. You must notify the Administrative Office of a divorce, legal separation or a child's loss of dependent status within 60 days after the date of the qualifying event. If you don't, your spouse, former spouse or dependent child will lose the right to elect COBRA continuation coverage

* 24 months if, as an active participant, you've had at least two years of earned eligibility in the last five years.
** You're required to provide proof of eligibility for Social Security disability benefits for continuation of coverage for the additional 11 months.

Once a qualifying event occurs and you notify the Administrative Office, you'll receive full details about COBRA continuation coverage, including the cost and duration of coverage. You must then notify the Administrative Office within 60 days of the date the notice is sent or coverage is lost, whichever is later, if you want to elect COBRA continuation coverage. Once you elect coverage, you'll have 45 days from the date you decided to elect COBRA continuation coverage to pay the initial monthly premium, retroactive to the date of the qualifying event. This 45-day grace period is required by law, and no extensions will be granted.

Premiums, which may change each year, will then be due monthly. If you fail to pay your premium within 30 days of its due date, your coverage will be terminated and won't be reinstated. This 30-day grace period is required by law, and no extension will be granted.

If you don't respond to the initial COBRA notice within 60 days, you'll no longer be eligible for COBRA continuation coverage.

Disability Extension of 18-Month Period of Continuation of Coverage
If you or your covered spouse or dependent children are determined by the Social Security Administration to be disabled at any time during the first 60 days of COBRA continuation coverage and you notify the Administrative Office in a timely fashion, you and your family can receive up to an additional 11 months of COBRA continuation coverage, for a total maximum of 29 months. You must make sure that the Administrative Office is notified of the Social Security Administration's determination within 60 days of the date of the determination and before the end of the 18-month period of COBRA continuation coverage. If you fail to provide such notice within this timeframe, you won't be eligible for the disability extension. This notice should be sent to the Eligibility Department. The cost of coverage during the disability extension is 150% of the cost of coverage if the disabled individual is covered.

Second Qualifying Event Extension of 18-Month Period of Continuation Coverage
If your family experiences another qualifying event during the COBRA continuation coverage period, your spouse and dependent children can get additional months of COBRA continuation coverage, up to a maximum of 36 months. This extension is available to your spouse and dependent children if you die, get divorced or legally separated or enroll in Medicare (Part A, Part B or both) after your COBRA coverage has commenced. The extension is also available to a dependent child when that child stops being eligible as a dependent child. In all of these cases, you must make sure that the Administrative Office is notified of the second qualifying event within 60 days of the event. If you don't provide the Administrative Office with notice of a second qualifying event within the 60-day period, coverage won't continue past the 18-month period.

Coverage Options
You can choose from among a number of plans if you elect COBRA continuation coverage. These are the same health plans that are available to you as an active participant, but some offer special plan options - for example, one with no dental coverage - or one with a lower level of benefits to reduce your cost. The plan options range from the least comprehensive, for which the premiums are lowest, to the most comprehensive, for which you pay the most. You'll receive complete information about your plan options and costs when you lose your active eligibility status for the Fund's health plans.

When you elect COBRA continuation coverage, your premiums will be based on the coverage option you select. These premiums are divided into three rate levels:

• Single coverage;
• Two-party coverage (you and a dependent); and
• Family coverage.

In addition to your premium payments, you'll also pay any applicable deductibles, coinsurance or copays. (See the Summary Of Benefits for details.)

When COBRA Continuation Coverage Ends
COBRA continuation coverage takes effect on the date of your qualifying event and continues until the earliest of the following:

• You fail to pay the initial COBRA premium within 45 days of the date you enroll for COBRA continuation coverage;
• You fail to pay subsequent premiums within 30 days of the due date;
• The 18-month, 24 month, 29-month or 36-month continuation period ends;
• With respect to the extension for disability, the date the person is no longer disabled;
• The date you or your dependents become covered, after the date you or your dependents elect COBRA continuation coverage, under another group health plan if the other plan doesn't impose any pre-existing condition exclusions on the qualified beneficiary;
• The date you or your dependents become enrolled in Medicare, after the date you or your dependents elect COBRA continuation coverage, or
• The Fund no longer provides group health care coverage.

If you have questions about your COBRA continuation coverage, contact the Administrative Office, or contact the nearest regional or district office of the U.S. Department of Labor's Employee Benefits Security Administration (EBSA). Addresses and phone numbers of EBSA offices are available through EBSA's web site at www.dol.gov/ebsa.

In order to protect your family's rights, you should keep the Administrative Office informed of any changes in the addresses of family members. You should also keep a copy, for your records, of any notices you send to the Administrative Office.