When Coverage Ends - Retiree COBRA / Back

When Coverage Ends

Coverage for you and your covered spouse ends on:

  1. The first day of a month for which the required self-payments are not received by the 30th day of the same month.
  2. The date when you are no longer eligible for Plan benefits.
  3. For specific benefits, the date when the covered maximum is reached for that covered participant or when the benefit is discontinued.
  4. The date when your TBT Plan ends.
  5. The first day of the month following the month in which the Employer from which you retired bargains out of TBT and into another group health plan and stops contributing to TBT on behalf of active employees. However, if your former Employer leaves the area or stops operations altogether, you may continue your eligibility in the Plan.

Coverage for your covered spouse ends at the same time yours ends, or sooner:
  1. When you divorce (on the first day of the month after your divorce is final).
  2. The first day of the month for which the required self-payment is not received by the 30th day of the same month.

HEALTH INSURANCE
PORTABILITY

When coverage ends, federal law requires that the Plan provide a Certificate of Group Health Plan Coverage to you. This certificate is intended for use by any new plan in which you enroll.


COBRA Coverage

The Consolidated Omnibus Budget Reconciliation Act (COBRA) is a federal law that requires certain group health plans to offer the spouse of a retired employee (if the spouse is covered by the plan) the option of continuing coverage by self-payment after eligibility in the Plan has ended due to divorce (a qualifying event described below).

  • If the retiree and covered spouse divorce, the spouse may continue coverage by self-payment for up to 36 months. A divorce must be reported to the Plan Administration Office within 60 days. Failure to do so on a timely basis stops COBRA eligibility.

While COBRA also provides that either the retiree’s death or a former Employer’s bankruptcy would be qualifying events if they led to a loss of eligibility, they are not qualifying events under this Plan since they do not result in a loss of eligibility.

Your spouse has a maximum of 60 days to elect COBRA coverage. A COBRA election form (called Notice of Qualifying Event) is in your Forms folder. If he or she needs a form, contact the Plan Administration Office.

The COBRA election period begins on the later of the following dates:

  1. The date coverage under the Plan would otherwise end because of the qualifying event.
  2. The date the qualified beneficiary is sent notice of his or her right to elect COBRA coverage.

COBRA Payments

Your spouse electing COBRA must pay the full monthly self-payment for the coverage elected. There may be no gap in coverage. Payments must be retroactive to the date when coverage ends.

Under COBRA, your spouse will pay the full cost of coverage plus a 2% administration fee—in other words, 102% of the cost of continuing coverage.

When COBRA Coverage Ends

The COBRA period, which started when your spouse experienced one of the qualifying events described in this section, ends on the earliest of:

  1. The end of the 36-month period described in this section.
  2. The first day of the month in which your spouse’s payment is not received within 30 days of the due date.
  3. The date when your spouse becomes covered under another group plan unless the new group plan contains any exclusions or limitations for pre-existing conditions that directly affect your spouse’s coverage. At the end of any such exclusions or limitations, COBRA eligibility under TBT ends.
  4. The date your spouse becomes eligible for Medicare.
  5. The date the Plan ends.
  6. The date when your former Employer stops providing Plan benefits to any retiree.

If at the end of your COBRA continuation of coverage period your spouse is enrolled in an HMO, he or she may enroll in an individual conversion plan offered by the HMO. This option may cost more and provide fewer benefits than the group health coverage.

The Plan’s COBRA provisions are meant to comply with applicable federal law. If changes in the law differ from the COBRA information provided here, the changes will govern.

If you have questions about COBRA eligibility or benefits, contact the Plan Administration Office.

IMPORTANT
The Plan Administration Office will mail your spouse’s COBRA notice to the home address listed on your TBT Retiree Enrollment Form. You must notify the Plan Administration Office whenever you or your spouse change your address.

If You Have Questions

Call the Plan Administration Office with your questions. Benefits under each TBT Plan are different. When calling, refer to your Plan as the Comprehensive Retiree Plan (CRP).

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