Understanding Your Continued Benefits Options The Questions You Are Most Likely Asking are… Now What? If I don’t have coverage available to me for a.

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Presentation transcript:

Understanding Your Continued Benefits Options

The Questions You Are Most Likely Asking are… Now What? If I don’t have coverage available to me for a temporary period of time after I leave TTUHSC, what am I going to do?

ELECT COBRA

 It is a continuation of coverage to covered employees, former employees, spouses, former spouses, and dependent children when group “health” coverage would otherwise be lost due to certain specific events.

 Medical  Dental  Vision

 For the benefits that are currently available to you and your covered dependents, you may elect to continue the coverage for one benefit or all benefits.  The decision is yours.

 A group health plan is required to offer COBRA continuation coverage only to qualified beneficiaries and only after a qualifying event has occurred.  A qualified beneficiary is an individual who was covered by a group health plan on the day before a qualifying event occurred and who is either an employee, the employee's spouse or former spouse, or the employee's dependent child.

 "Qualifying events" are events that cause an individual to lose group health coverage. ◦ The following are qualifying events for a covered employee if they cause the covered employee to lose coverage:  Termination of the covered employee's employment for any reason other than "gross misconduct"; or  Reduction in the covered employee's hours of employment. ◦ The following are qualifying events for a spouse and dependent child of a covered employee if they cause the spouse or dependent child to lose coverage:  Termination of the covered employee's employment for any reason other than "gross misconduct";  Reduction in hours worked by the covered employee;  Covered employee becomes entitled to Medicare;  Divorce or legal separation of the spouse from the covered employee; or  Death of the covered employee. ◦ In addition to the above, the following is a qualifying event for a dependent child of a covered employee if it causes the child to lose coverage:  Loss of "dependent child" status under the plan rules

 Upon your leaving TTUHSC, you and each covered dependent will receive a COBRA ELECTION NOTICE.  Each qualified beneficiary has 60 days after the loss of coverage in which to elect continuation coverage.

YOU DO!

 Qualified beneficiaries who elect to continue coverage, have 45 days after the date of election in which to make the initial premium payment.  NOTE: ALL PREMIUM DUE MUST BE PAID BY THE END OF THIS PERIOD

 The 1 st of each month  When you receive your COBRA Election Notice and Form, the cost of continuing your coverage will be included.

 Watch for your COBRA Election Notice in your mail  Decide if you need to continue the coverage  Complete the COBRA Election Form to either elect coverage or decline  Return, Return, Return…return the election form to the address indicated in the instructions.  Pay, Pay, Pay…pay your premium on time

 18 months (for termination of employment other than gross misconduct) ◦ However, you can terminate the COBRA coverage at any time

 Monica Loya The Scioli Group