COBRA

Your benefits through Roehl end at midnight the last day you work. You and your qualifying dependents may have the right to elect COBRA at that time.

COBRA is the term often used to identify health plan continuation coverage. The term comes from the law that established the rules for continuation coverage (Consolidated Omnibus Budget Reconciliation Act of 1986).

This notice is very important. Please read it carefully.

Notice of Employee Group Health Plan Continuation Coverage

Under Federal law, we are required to offer covered employees and covered family members the opportunity for a temporary extension of health coverage (called “continuation coverage”) at group rates when coverage under the health plan would otherwise end due to certain qualifying events. This notice is intended to inform all plan participants, in summary fashion, of your potential future options and obligations under the continuation coverage provisions of law. Should an actual qualifying event occur in the future, you will receive additional information and the appropriate election notice at that time. Please take special note of your notification obligations outlined in the paragraphs that follow.

Qualifying Events for Covered Employee

If you are the covered employee, you may have the right to elect this health plan continuation coverage if you lose your group health coverage because of a termination of your employment (for reasons other than gross misconduct on your part) or a reduction in your hours of employment.

Qualifying Events for Covered Spouse

If you are the covered spouse of an employee, you may have the right to elect this health plan continuation coverage for yourself if you lose group health coverage because of any of the following reasons:

• Termination of your spouse’s employment (for reasons other than gross misconduct) or reduction in your spouse’s hours of  employment.
• Death of your spouse.
• Divorce or, if applicable, legal separation from your spouse.
• Your spouse becomes entitled to Medicare.

Qualifying Events for Covered Dependent Children

If you are the covered dependent child of an employee, you may have the right to elect continuation coverage for yourself if you lose group health coverage because of any of the following reasons:

• Termination of the employee's employment (for reasons other than gross misconduct) or reduction in the employee's hours of employment.
• Death of the employee.
• Parent's divorce or, if applicable, legal separation.
• The employee becomes entitled to Medicare.
• You cease to be a "dependent child" under the terms of the health plan.

We must be notified of certain employee, spouse and dependent status changes.

Under the law, an employee, spouse or other family member has the responsibility to notify us of a divorce, legal separation or a child losing dependent status under our health plan. This notification must be made within 60 days from whichever date is later, the date of the event or the date on which health plan coverage would be lost under the terms of the insurance contract due to the event. If this notification is not completed within the required 60-day notification period, then rights to continuation coverage will be forfeited.

Upon notification of a qualifying event, a COBRA election form notifying all covered individuals (also known as qualified beneficiaries) of their rights to elect continuation coverage will be mailed to the most current address. Each qualified beneficiary has independent election rights and will have 60 days to elect continuation coverage. The 60-day election window is measured from the date health plan coverage is lost due to the event or from the date of notification, whichever is later. This is the maximum period allowed to elect continuation coverage as the plan does not provide an extension of the election period beyond what is required by law. If a qualified beneficiary does not elect continuation coverage within this election period, then rights to continue health insurance will end and they cease to be a qualified beneficiary.