| COBRA Coverage Information |
| All Employees, Spouses, and Dependents: |
Federal law requires the Harrison Trust to offer employees and dependents the opportunity to elect a temporary extension of medical, dental, and vision coverage (called "COBRA Continuation Coverage"). This coverage is offered at group rates in certain instances where coverage under this Plan and any insured plan offered by the Board of Trustees would otherwise end. You do not have to show you are insurable to elect COBRA Continuation Coverage. However, you must pay the total premium and administrative costs for COBRA Continuation Coverage. |
| Qualifying Events |
If you are an employee covered by this Plan or an insured
plan offered by the Board of Trustees, you have the right to elect COBRA
Continuation Coverage for yourself, your spouse, and your dependents if
you lose coverage because of any one of the following two qualifying events:
If you are the spouse of an employee covered by this Plan or an insured plan offered by the Board of Trustees, you have the right to elect COBRA Continuation Coverage for yourself and your dependents if you lose coverage because of any of the following four qualifying events:
If you are a dependent child of an employee covered by this Plan or an insured plan offered by the Board of Trustees, you have the right to elect COBRA Continuation Coverage if you lose coverage because of any of the following five qualifying events:
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| Notices and Election |
| Under this Plan your spouse's group coverage ends the day
that a divorce or legal separation occurs (coverage is lost for the spouse
only). Under this Plan, a dependent child's group coverage ends on the
last day of the month in which the dependent child loses dependent status.
Under COBRA, you, your spouse or your dependents have the responsibility to notify the Plan Administrator of divorce, legal separation, or child losing dependent status. You, your spouse or your dependents must give this notice to the Plan Administrator no later than 60 days after the divorce, legal separation, or child losing dependent status. If you, your spouse or your dependent fails to notify the Plan Administrator during the 60-day notification period, any family member who loses coverage will not be offered the option to elect COBRA Continuation Coverage. You may be liable for claims if coverage continues beyond the termination date of a divorce, legal separation, or child losing dependent status, because you, your spouse or your dependent has failed to notify the Plan Administrator. Once the Plan Administrator is notified, coverage will end retroactively (as of the day of the divorce or legal separation or the last day of the month in which the child loses dependent status). You, your spouse or dependent must reimburse the Plan for claims paid, if any, after the coverage end date. The same termination and reimbursement requirement will apply if you, your spouse, or your dependent child gives notice of the qualifying event within the 60-day notice period, but then fails to timely elect and pay for COBRA Continuation Coverage. If the Plan Administrator is notified in a timely manner that one of the above three events (divorce, legal separation or child losing dependent status) has happened, the Plan Administrator will notify the family member of the right to elect COBRA Continuation Coverage. You, your spouse or dependent will also be notified of the right to elect COBRA Continuation Coverage automatically (without any action required by you or a family member) when group health coverage is lost because your employment ends, reduction in your hours, death, or becoming enrolled in Medicare Part A or Part B. You, your spouse or dependents must elect COBRA Continuation Coverage within 60 days after group health coverage ends or, if later, 60 days after the Plan Administrator sends you or your family member notice of your right to elect COBRA Continuation Coverage. If you, your spouse or your dependents do not elect COBRA Continuation Coverage within the 60-day election period, you will lose your right to elect COBRA Continuation Coverage. The election to accept COBRA Continuation Coverage is effective on the date the election is sent to the Plan Administrator. |
| Benefits Available Under COBRA Continuation Coverage |
| You, your spouse and each dependent has the right to elect COBRA Continuation Coverage for medical and prescription drug benefits only, or for medical, prescription drug, dental and vision benefits. Any other benefits provided to you or a family member are not subject to the COBRA continuation provisions. Cobra Continuation Coverage is identical to the coverage provided to similarly situated employees and dependents. If the benefits available to similarly situated employees and dependents are modified, COBRA Continuation Coverage will be modified in the same way. |
| Making the Necessary Payments |
| You or a family member must pay the premium for the initial premium months by the 45th day after electing COBRA continuation Coverage. The initial premium months are the months that end on or before the 45th day after the day of the COBRA election. All other premiums are due on the first of the month, subject to a 30-day grace period. A premium payment is made on the date it is sent to the Plan Administrator. |
| How Long COBRA Continuation Coverage Lasts |
1. 36 months. If your spouse or your dependent child loses coverage because of death, divorce, legal separation, your enrollment in Medicare Part A or Part B, or because the dependent child loses his status as a dependent under this Plan or an insured plan offered by the Board of Trustees, the maximum coverage period (for the spouse and dependent child) is three years from the date coverage would otherwise end. 2. 18 months. If you, your spouse, or dependent child loses coverage because the employee's employment ends or reduction in hours, the maximum COBRA Continuation Coverage period (for you, your spouse and dependent child) is 1 months from the date coverage would otherwise end. There are three exceptions:
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| Newborn Children and Children Placed for Adoption with the Employee After the Qualifying Event |
If, during the COBRA Continuation Coverage, a child is born to you or is placed for adoption with you, the child is considered a qualified beneficiary entitled to COBRA Continuation Coverage. You or your spouse has the right to elect COBRA Continuation Coverage for the child, provided the child satisfies the otherwise applicable eligibility requirements (for example, age). You or your spouse must notify the Plan Administrator of the birth or placement of a child for adoption. |
| Termination of COBRA Continuation Coverage Before the End of the Maximum Period |
COBRA Continuation Coverage for you, your spouse or your
dependent child will automatically end (even before the end of the maximum
coverage period)
on the last day of the month in which any of the following events occur:
A preexisting exclusion or limitation of another group health plan may not apply to you, or may be satisfied by you, depending on the length of your coverage under this Plan or another group plan. |
| Automatic Coverage for Your Spouse and Dependent Children Choosing COBRA Continuation Coverage |
When you elect COBRA Continuation Coverage, coverage for your spouse and your dependent children will continue automatically unless your spouse independently declines COBRA Continuation Coverage. If you choose not to elect COBRA Continuation Coverage, your spouse and your dependent may still choose COBRA Continuation Coverage. Of course, in all circumstances, anyone electing COBRA Continuation Coverage must pay the required premium. |
| Transfer Rights |
| If you are covered by an HMO that covers a limited geographic area and you relocate to another area where employers contributing to the Harrison Trust have an active work force, you may be entitled to elect coverage available to other employees working in that area. If you find yourself in this situation, contact the Plan Administrator. Of course, under no circumstances would such a transfer prolong your maximum COBRA Continuation Coverage. |
| Other Information |
| If you, your spouse, or your dependent child has any questions about COBRA Continuation Coverage, please contact the Plan Administrator. |
| All information provided on this web site is in summary and intended to provide highlights of your plans. We strongly recommend referring to the Plan booklet for complete details before making any decisions related to your eligibility, benefits and coverage. |