Page 27 - Great Circle 2021 Benefits Guide
P. 27
2021
Legal Notices
Note: you may have other options available to you when If you’re the spouse of an employee, you’ll become a qualiied
you lose group health coverage. When you become eligible beneiciary if you lose your coverage under the Plan because of
for COBRA, you may also become eligible for other coverage the following qualifying events:
options not provided by your employer that may cost less Your spouse dies;
than COBRA continuation coverage. For example, you may be
eligible to buy an individual plan through the Health Insurance Your spouse’s hours of employment are reduced;
Marketplace. By enrolling in coverage through the Marketplace, Your spouse’s employment ends for any reason other than
you may qualify for lower costs on your monthly premiums and his or her gross misconduct;
lower out-of-pocket costs. Additionally, you may qualify for a Your spouse becomes entitled to Medicare beneits (under
30-day special enrollment period for another group health plan Part A, Part B, or both); or
for which you are eligible (such as a spouse’s plan), even if that
plan generally doesn’t accept late enrollees. You become divorced or legally separated from your
spouse. Note that if your spouse cancels your coverage in
COBRA Continuation Coverage and anticipation of a divorce* and a divorce* later occurs, then
“Qualifying Events” the divorce* will be considered a qualifying event even
though you actually lost coverage earlier. If you notify the
COBRA continuation coverage is a continuation of plan Plan Administrator or its designee within 60 days after the
coverage when coverage would otherwise end because of a life divorce* and can establish that the employee canceled
event known as a “qualifying event.” Speciic qualifying events the coverage earlier in anticipation of the divorce,* then
are listed later in this notice. COBRA continuation coverage COBRA coverage may be available for a period after the
must be ofered to each person who is a “qualiied beneiciary.” divorce (but not for the period between the date your
A qualiied beneiciary is someone who will lose coverage under coverage ended, and the date of divorce).* But you
the plan because of a qualifying event. Depending on the type must provide timely notice of the divorce* to the Plan
of qualifying event, employees, spouses of employees, and Administrator or its designee or you will not be able to
eligible children of employees may be qualiied beneiciaries. obtain COBRA coverage after the divorce.* See the rules
Certain newborns, newly-adopted children, and alternate in the box below, under the heading entitled, “Notice
recipients under qualiied medical child support orders may Requirements,” regarding the obligation to provide notice,
also be qualiied beneiciaries. This is discussed in more and the procedures for doing so.
detail in separate paragraphs below. Under the plan, qualiied * Or legal separation
beneiciaries who elect COBRA continuation coverage generally
must pay for this continuation coverage. Your covered eligible children will become qualiied beneiciaries
If you’re an employee, you’ll become a qualiied beneiciary if if they lose coverage under the Plan because of the following
you lose your coverage under the Plan because of the following qualifying events:
qualifying events: The parent-employee dies;
Your hours of employment are reduced; or The parent-employee’s hours of employment are reduced;
Your employment ends for any reason other than your The parent-employee’s employment ends for any reason
gross misconduct other than his or her gross misconduct;
The parent-employee becomes entitled to Medicare
beneits (Part A, Part B, or both);
The parents become divorced or legally separated; or
The child stops being eligible for coverage under the Plan
as an eligible child
27
Legal Notices
Note: you may have other options available to you when If you’re the spouse of an employee, you’ll become a qualiied
you lose group health coverage. When you become eligible beneiciary if you lose your coverage under the Plan because of
for COBRA, you may also become eligible for other coverage the following qualifying events:
options not provided by your employer that may cost less Your spouse dies;
than COBRA continuation coverage. For example, you may be
eligible to buy an individual plan through the Health Insurance Your spouse’s hours of employment are reduced;
Marketplace. By enrolling in coverage through the Marketplace, Your spouse’s employment ends for any reason other than
you may qualify for lower costs on your monthly premiums and his or her gross misconduct;
lower out-of-pocket costs. Additionally, you may qualify for a Your spouse becomes entitled to Medicare beneits (under
30-day special enrollment period for another group health plan Part A, Part B, or both); or
for which you are eligible (such as a spouse’s plan), even if that
plan generally doesn’t accept late enrollees. You become divorced or legally separated from your
spouse. Note that if your spouse cancels your coverage in
COBRA Continuation Coverage and anticipation of a divorce* and a divorce* later occurs, then
“Qualifying Events” the divorce* will be considered a qualifying event even
though you actually lost coverage earlier. If you notify the
COBRA continuation coverage is a continuation of plan Plan Administrator or its designee within 60 days after the
coverage when coverage would otherwise end because of a life divorce* and can establish that the employee canceled
event known as a “qualifying event.” Speciic qualifying events the coverage earlier in anticipation of the divorce,* then
are listed later in this notice. COBRA continuation coverage COBRA coverage may be available for a period after the
must be ofered to each person who is a “qualiied beneiciary.” divorce (but not for the period between the date your
A qualiied beneiciary is someone who will lose coverage under coverage ended, and the date of divorce).* But you
the plan because of a qualifying event. Depending on the type must provide timely notice of the divorce* to the Plan
of qualifying event, employees, spouses of employees, and Administrator or its designee or you will not be able to
eligible children of employees may be qualiied beneiciaries. obtain COBRA coverage after the divorce.* See the rules
Certain newborns, newly-adopted children, and alternate in the box below, under the heading entitled, “Notice
recipients under qualiied medical child support orders may Requirements,” regarding the obligation to provide notice,
also be qualiied beneiciaries. This is discussed in more and the procedures for doing so.
detail in separate paragraphs below. Under the plan, qualiied * Or legal separation
beneiciaries who elect COBRA continuation coverage generally
must pay for this continuation coverage. Your covered eligible children will become qualiied beneiciaries
If you’re an employee, you’ll become a qualiied beneiciary if if they lose coverage under the Plan because of the following
you lose your coverage under the Plan because of the following qualifying events:
qualifying events: The parent-employee dies;
Your hours of employment are reduced; or The parent-employee’s hours of employment are reduced;
Your employment ends for any reason other than your The parent-employee’s employment ends for any reason
gross misconduct other than his or her gross misconduct;
The parent-employee becomes entitled to Medicare
beneits (Part A, Part B, or both);
The parents become divorced or legally separated; or
The child stops being eligible for coverage under the Plan
as an eligible child
27
