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Click on the Logo Below for a list of Tulsa Area Dentist. For more information go to the DenteMax Page!

 

COBRA

Consolidated Omnibus Reconciliation Act of 1985

In addition to the Company’s continuation of coverage provision, employees and/or dependents may be entitled to continue healthcare at their own expense under COBRA

Qualifying Events

EMPLOYEES

 

Ø

Termination of employment (for any reason other than gross misconduct)

 

Ø Reduction in the hours of employment
SPOUSES AND DEPENDENTS
  Ø Employee’s termination of employment (other than gross misconduct)
   Ø Employee’s reduction in the number of hours of employment
  Ø Covered employee becoming entitled to Medicare
  Ø Divorce or legal separation
   Ø Death of the covered employee
  Ø Loss of dependent status as defined in the Company’s group healthcare plans
Notification Requirements

The employee, spouse, or dependent child MUST notify the Company (NESC) within 60 days of the qualifying event if the event is:

  w Divorce
  w Dependent child’s loss of dependent status
  w Death of the employee if it results in loss of coverage
For “other” Qualifying Events:
  w The Company will notify the COBRA Coordinator (presently UniCare).
  w UniCare will send additional information to individuals eligible to elect COBRA.
  w If the employee or dependent elects to continue coverage under COBRA, they must return an election form to UniCare within 60 days of receipt of such form.

Duration of COBRA Coverage

 

Up to 18 months for covered employees, their spouses and dependents

 

ð

When coverage is lost as a result of a termination or reduction in hours

  Up to 29 months for COBRA beneficiaries
 

ð 

Applies to beneficiaries who are disabled at the time of the qualifying event or within 60 days of COBRA coverage
  Up to 36 months for spouses and dependents
  ð Applies if facing a loss of employer-provided coverage due to an employee’s death, divorce or legal separation

COBRA COVERAGE'S

 

If eligible to continue coverages, it will be the same coverage the member was eligible for before the qualifying event

 

Example:

If the member and dependents were enrolled in traditional medical and dental, they would be offered the same coverages if they elect to continue benefits under COBRA.

COBRA COSTS
  COBRA is 102% of the full group rate in effect at the time continued coverage begins.
 

Exception: 

If the member is disabled at the time of the termination, they are eligible for COBRA for 29 months rather than 18 months but the cost for the additional 11 months is 150% of the regular full group rate rather than the normal 102%.

Termination of COBRA

Coverage under COBRA will be terminated before the end of the 18, 29 or 36 month period for any of the following reasons:

  ð Failure to make required monthly payments
  ð Voluntary cancellation of coverage
  ð The Company no longer provides group health care coverage to any of its employees or retirees
Contact Information
Notify the NESC within 60 days of the  Qualifying Event @ 1-800-248-4444

Inquiries regarding COBRA eligibility, information or election forms, call UniCare @ 1-800-843-8184 (ask for COBRA unit)

 

 

  

 

 

 

 

 

 

 

 

 

 

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Last modified: 08/20/07