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Continuation of Coverage (COBRA)

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The Consolidated Omnibus Budget Reconciliation Act of 1985 - ("COBRA") - requires that employees be allowed to continue benefit coverage for health, dental and, if applicable, vision plans under certain circumstances. These circumstances include employee termination or death. Dependents may also be eligible for continuation of benefits, because of age, divorce or legal separation, or loss of coverage because of Medicare eligibility. The employee must pay the cost of COBRA continuation. The cost of coverage will be at 102% of the current cost for coverage for eligible employees. If the plan changes for active employees while you or your dependents are on COBRA continuation, the same changes will apply to you and your dependent. Individuals on COBRA will also have the same right as active employees to change plans during an annual open enrollment each August. It is the employee's responsibility to contact the Employee and Public Services Department: When a dependent ceases to be eligible for group coverage In the event of a divorce or legal separation. Reminder: Please notify the Benefits Division immediately in the event of a divorce, legal separation or your child ceasing to be an eligible dependent on your plan so we may offer them the COBRA continuation option. More information on COBRA is available by calling (650) 363-4227 or by writing to the following address: EMPLOYEE & PUBLIC SERVICES DEPARTMENT - BENEFITS DIVISION 455 COUNTY CENTER REDWOOD CITY, CA 94063-1663 ATTN: COBRA COORDINATOR PLEASE SHARE THIS INFORMATION WITH YOUR SPOUSE AND DEPENDENTS Eligibility To be eligible for COBRA coverage you must SATISFY ALL of these conditions: Be an employee or dependent of an employee of San Mateo County as of the date of the event qualifying you for coverage; Be a member of one of the County group medical and/or dental plans; Have lost your group coverage as a result of a qualifying event. Qualifying Events The qualifying events are described below: Group Continuation coverage is available for up to 18 months if one of the following "qualifying events" occur: Your employment terminates for any reason other than gross misconduct; Your work hours are reduced to less than 20 hours per week and no longer qualify for group coverage. Group Continuation Coverage is available to eligible dependents for up to 36 months if one of the following "qualifying events" occur: Your spouse or dependent(s) lose coverage due to your death; Your spouse loses coverage because of divorce or legal separation; Your dependent child marries, reaches, the age limit (30) for continued coverage under your plans (Aetna Health, Blue Shield Health/POS, Blue Shield Dental, County Self Funded Dental, Delta Dental PMI, and Vision) or if you no longer are responsible for 50% of their financial support or there is a change in custody. Terminating Events The terminating events are described below: Group Continuation Coverage will terminate earlier than the 18 or 36 months in any of the following circumstances: The County terminates the employer provided health and/or dental plans; Your or your dependents monthly payment is not received timely by the Employee & Public Services Department; You or your dependent(s) become covered by any other group health plan; You or your dependent becomes eligible for Medicare (health only effected); or Your former spouse remarries and becomes covered under another group health plan. Coverage and Monthly Billing If you choose to continue your medical, vision, and/or dental coverage after a qualifying event, you must stay with the same group plan that you were enrolled in prior to the qualifying event. You may, however, change plans during open enrollment in August of each year. YOU WILL BE CHARGED THE FULL COST OF COVERAGE PLUS A 2% ADMINISTRATIVE CHARGE. The County will no longer pay a portion of this coverage. You have 45 days after the date you elect the continuation coverage to make your first payment and thereafter payments must be made by the 1st of each month to the Employee & Public Services Department. Your benefits will be identical to those available to County employees and are subject to the same changes as affect the County plans. Your rates are also subject to the same changes as affect the County plans. How to Apply If one of the above qualifying events occurs, you or one of your dependents will receive information explaining the procedure and the necessary forms to elect COBRA. You will have 60 days to elect COBRA, if you fail to meet this deadline you may not be allowed to enroll. Your Responsibility If one of your children ceases to be a dependent child under the regulations of our group coverage because of age or marriage or you become divorced or legally separated from your spouse, you are responsible for notifying the County of the occurrence of any of these events. The County will then provide a notice to your dependent child or estranged spouse regarding the continuation of group health coverage. This will be sent to your home address in our records, unless otherwise specified, and you are responsible to forward to your dependent or spouse. Individual Conversion Option You may apply for individual plan coverage with Blue Shield Health/POS, Kaiser, Aetna Health or Delta Dental PMI (there is no conversion for the County Self Funded Dental Plan or VSP) if any of the following events occur: You reach the time limit for group continuation coverage (i.e.: 18 or 36 months); You or your dependents become entitled to Medicare benefits; or You fail to make timely payments to the County for your COBRA continuation coverage. Option Summary Your options, upon a qualifying event taking place, are: You may elect COBRA coverage in your current medical, dental, and/or vision plans; You may decline coverage. If you do not elect COBRA continuation coverage, your group coverage will end; or You may convert to individual plan coverage. You must do this within 31 days of the loss of your group coverage. Life lnsurance Coverage You will be able to convert your coverage for life insurance within 31 days of the date your regular group life insurance coverage ends. You will be sent a conversion card to mail to the Life Insurance company.