SBF Summary Plan Handbook - CWA Local 1180

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SBF Summary Plan Description 06-11-12 How Long Does COBRA Continuation Coverage Last COBRA Continuation Coverage is a temporary continuation of coverage. When the qualifying event is the death of the covered member, your divorce or legal separation, or a dependent child losing eligibility as a dependent child, COBRA Continuation Coverage lasts for up to 36 months. COBRA Continuation Coverage will be terminated before the end of the maximum period for any of the following reasons: ‣ You do not pay the amount for your COBRA Continuation Coverage on time or within certain grace periods; ‣ The CWA Local 1180 Security Benefits Fund ceases to provide any group health plan for its members; ‣ You or one of your covered family members becomes covered under another group health plan that does not impose any pre-existing condition exclusion for a pre-existing condition of the qualified beneficiary; ‣ If covered member coverage would be terminated for cause, such as filing a fraudulent claim. How Do I Elect COBRA Continuation Coverage Each qualified beneficiary has an independent right to elect continuation coverage. This means that COBRA Continuation Coverage may be elected for some members of the family but not others (including one or more dependents even if the covered member’s spouse does not elect it), as long as those for whom it is chosen were covered by the Fund on the day before the qualifying event (employment ends, death of covered member, divorce, etc) that led to the loss of regular coverage under the Fund. A parent may elect or reject COBRA coverage on behalf of dependent children living with him or her. If you do not indicate on whose behalf you are electing COBRA Continuation Coverage, the Fund will act as if you have not elected COBRA for all family members who were receiving active coverage. Within 14 days after the Fund Administrator receives notice that a qualifying event has occurred, the Fund Administrator will provide you with a notice of your right to elect continuation coverage. IMPORTANT: When electing COBRA Continuation Coverage you MUST complete the COBRA Continuation of Coverage “ELECTION FORM" by checking off the appropriate - 20 -
SBF Summary Plan Description 06-11-12 boxes, following the Election Form instructions and returning the form to the Fund Office. You must mail it to the address shown on the form. The completed form must be mailed no later than 65 days from the post-marked date of the Election Form. If you do not submit a completed Election Form by this date, you will lose your right to elect continuation coverage. A check for the first month’s payment should be included with the Election Form. You will not be billed separately for the amount due for the period prior to the time your request for COBRA Continuation Coverage is received. If the check is not included with the Election Form, you will have 45 days from the date you return your election form to make this payment, but no benefits will be paid or covered services provided until your payment is received. Even though you have 45 days to make your initial payment, it is advisable to include the premium payment together with the Election Form in order to receive prompt payment of claims. You need to remit payment for any complete months for which you have coverage. All future payments are due no later than 30 days after the beginning of the month. Remember that you will not receive a monthly bill. The premium is subject to change every 12 months. The costs are fixed for the period September 1 to August 31. All checks must be made payable to the CWA Local 1180 Security Benefits Fund. In considering whether to elect continuation coverage, you should take into account that a failure to continue your group health coverage will affect your future rights under federal law. First, you can lose the right to avoid having pre-existing condition exclusions applied to you by other group health plans if you have more than a 63-day gap in health coverage, and election of continuation coverage may help you not have such a gap. Second, you will lose the guaranteed right to purchase individual health insurance policies that do not impose such pre-existing condition exclusions if you do not get continuation coverage for the maximum time available to you. Finally, you should take into account that you have special enrollment rights under federal law. You have the right to request special enrollment in another group health plan for which you are otherwise eligible (such as a plan sponsored by your spouse’s employer) within 30 days after your group health coverage ends because of the qualifying event listed above. You will also have the same special enrollment rights at the end of continuation coverage if you get continuation coverage for the maximum time available to you. - 21 -
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SBF Summary Plan Handbook - CWA Local 1180

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