C o n n e c t i c u t C a r p e n t e r s H e a l t h F u n d P l a n

COBRA

 


When you’re no longer eligible for benefits under the Health Fund due to certain reasons, you and your dependents don’t have to go without coverage — you may be able to buy it from the Health Fund under the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). You must notify the Health Fund within 60 days of losing eligibility if you want to elect coverage under COBRA.

 

COBRA is a continuation of your coverage, which means that you don’t have to prove that you’re in good health to be covered.

 

If you lose eligibility because you don’t have enough hours, you and your dependents may buy coverage for up to 18 months.

 

If you should get divorced, become eligible for Medicare or die, your dependents can continue their existing coverage under COBRA for up to a total of 36 months. If one of these events occurs while your dependents are on COBRA coverage because you had insufficient hours, they can elect to increase their COBRA coverage period from 18 to 36 months from the original event. They must notify the Health Fund Office within 60 days of the event.

 

If you and your dependents are on COBRA coverage because you had insufficient hours and one of you becomes disabled during the first 60 days of COBRA coverage, you may elect to continue your coverage for up to 11 additional months. To do so, before the initial 18-month continuation period expires, the disabled person must:

 

·            receive a Social Security Disability Award, and

·            notify the Health Fund within 60 days of receiving the award.

 

And if one of your children is no longer an eligible dependent, he or she may buy coverage for up to a total of 36 months.

 

You or your dependents have to notify the Health Fund Office within 60 days of the later of:

 

·            the date a change takes place, such as a child turning age 19 or leaving school, or you get divorced or legally separated, or

·            the day the person would lose coverage because of such a change.

 

The Health Fund Office will send you a COBRA Continuation Coverage form to complete, sign and return. If you or your dependents don’t return your form to the Health Fund Office on time, you will lose your right to continue your coverage.

 

 


 

A Bit of Information

If you’re Terminated for Cause, fail to notify the Health Fund in time of a change such as divorce, separation or change in eligibility of a dependent child or if the Health Fund makes changes that exclude you from participating, you and your dependents will not be eligible to continue your benefits under COBRA. 

 

What COBRA Coverage Is Available?

The Health Fund offers you and/or each of your dependents the option of buying the same coverage you had or the same coverage minus dental or vision care benefits.

 

COBRA Full coverage includes Medical, Dental, Vision and Prescription Drug coverage. COBRA Reduced coverage includes Medical and Prescription Drug coverage only. Life Insurance, AD&D and Weekly Disability Income benefits are not available under COBRA.

 

When Does COBRA Coverage End?

COBRA coverage ends if:

 

·            you don’t make your payment to the Health Fund by the first of the month (Your coverage will end on the last day of the month prior to the month your payment is due.)

·            you become eligible for Medicare

·            you become covered under another plan that didn’t cover you when you lost Health Fund coverage, unless that plan has an exclusion or limitation provision for pre-existing conditions

 

If your COBRA coverage is terminated, it may not be reinstated, unless you become eligible again for coverage under the Health Fund, lose eligibility and elect COBRA coverage once again.

 

How Much Will It Cost?

The Health Fund will charge people on COBRA no more than 102% of the cost of coverage for Active Members and their dependents for the first 18 or 36 months, and no more than 150% for the additional 11 months allowed for disabled individuals, as allowed by law.

 

Your first COBRA payment will cover the period from the date you would have lost coverage through the current month. You have 45 days to make your first payment. After that, COBRA payments are due by the first of the month of coverage.

 

A Bit of information

Your decision to continue your medical coverage under the Health Fund is an important one, and it hinges on many things — like other coverage that may be available to you. So if you skipped over this section, read it before you make up your mind. If you miss your chance to buy COBRA coverage, you can’t buy it later on.

 

 

 

C o n n e c t i c u t C a r p e n t e r s H e a l t h F u n d