TITLE: Employee And Beneficiary Continuation Coverage
The Department shall provide continuation coverage through its employee group medical and dental insurance plans to all individuals eligible for such coverage under Title X of the federal Consolidation Omnibus Budget Reconciliation Act of 1986 (COBRA), as follows:
Employee Continuation Coverage: An offer of continuation coverage will be made to employees who would lose coverage because of 1) termination of employment; or 2) reduction in work hours.
Beneficiary Continuation Coverage: Continuation coverage will be offered to 1) divorced, legally separated, or widowed spouses and their dependent children; 2) dependent children who would lose coverage as dependents when they attain the limiting age under the plan; and 3) spouses and dependents ineligible for Medicare when the covered employee elects Medicare coverage and loses or refuses group plan coverage.
Continuation Period: Coverage may be continued from the date the employee's state group insurance coverage ends through the earliest of the following:
- If the employee qualifies for continuation due to termination of employment or a reduction in work hours, coverage may be continued for 18 months; 29 months if disabled per the Social Security Administration at any time during the first 60 days of COBRA coverage;
- If the employee qualifies for continuation for any other reason, or beneficiaries elect continuation coverage, coverage may be continued for 36 months;
- The date the employee becomes entitled to Medicare, or becomes covered under another group health insurance plan as a result of employment, re-employment, or remarriage, unless there are pre-existing conditions not covered by the plan;
- The end of the last month for which the premium is paid, on a timely basis;
- The date the State group insurance plan is terminated.
The coverage shall be identical to the coverage in effect at the time the employee or beneficiary becomes eligible for continuation coverage. Any person covered at the time of the qualifying event can elect continuation coverage, including a spouse or dependent, even if the former employee does not elect to continue. The total costs of the coverage (both employer's and employee's share) must be paid by the individual receiving the coverage.
- The Department shall notify the Department of Administrative Services-Human Resources Enterprise each month of any terminations of employment during the month.
- The Department of Administrative Services-Human Resources Enterprise then notifies the former employee of options available for continuing coverage for both the individual and his/her beneficiaries. Existing regulations would govern options and costs for such coverage.
- Active employees who have spouses or dependent children that qualify for beneficiary continuation coverage must notify the Personnel Technician within 60 days of the qualifying event. The Personnel Technician must then notify the spouse and/or dependent children of the options available to continue their coverage and send out the related insurance application(s).
- The former employee and/or beneficiaries must complete a COBRA Notification/Election form and return the form to DAS-HRE within 60 days after the later of: (a) the date coverage would otherwise end, or (b) the date of the COBRA Notification/Election notice. If coverage is elected, insurance application(s) must be completed and returned to DAS-HRE along with the COBRA Notification/Election form. Insurance applications can be obtained from the Personnel Technician.