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After your employees enroll in our health and dental plans, we will send them information explaining their continuation rights and options. An individual is entitled to continuation coverage if he or she is a qualified beneficiary who experiences a qualifying event.
A qualified beneficiary can be an employee, spouse, or dependent(s) who is covered under the employer’s group plan on the day before a qualifying event takes place. The only exception to this rule is a child who is born to, or placed for adoption with, a qualified beneficiary who was previously the covered employee during the COBRA continuation period also becomes a qualified beneficiary.
Note: If your policy covers domestic partners, the Trust extends continuation coverage to domestic partners and their biological or legally adopted children who were covered under the group plan on the day before a qualifying event took place.
A qualifying event is any of the following which causes a qualified beneficiary to lose his or her coverage under the employer’s group plan:
- Death of the covered employee.
- Termination of the covered employee’s employment.
- Reduction in the covered employee’s hours.
- Divorce or annulment of the covered employee’s marriage.
- Covered employee’s eligibility for Medicare benefits.
- Loss of a dependent child’s eligibility for coverage under the plan.
Electing continuation coverage
Qualified beneficiaries must choose, or elect, continuation coverage in writing within a specific time period. This election period ends 60 days after the later of the following dates:
- The date on which coverage would otherwise end because of a qualifying event.
- The date the written notice and election form is provided to the qualified beneficiary by the Trust.
If a qualified beneficiary elects continuation coverage, the Trust will manage all billing and collect premium payments. The qualified beneficiary will be billed directly at the same time that you are billed for active employees.