Page 25 - Draken Intl. 2022 OE Flipbook
P. 25
2022 LEGISLATIVE NOTICES
WHCRA Notice COBRA Rights (cont.)
If you have had or are going to have a mastectomy, you You may have other options available to you when you
may be entitled to certain benefits under the Women’s lose group health coverage. For example, you may be
Health and Cancer Rights Act of 1998 (WHCRA). For eligible to buy an individual plan through the Health
individuals receiving mastectomy-related benefits, Insurance Marketplace. By enrolling in coverage
coverage will be provided in a manner determined in through the Marketplace, you may qualify for lower
consultation with the attending physician and the costs on your monthly premiums and lower out-of-
patient, for: pocket costs.
All stages of reconstruction of the breast on which the Additionally, you may qualify for a 30-day special
mastectomy was performed.
enrollment period for another group health plan for
Surgery and reconstruction of the other breast to produce which you are eligible (such as a spouse’s plan), even if
a symmetrical appearance.
that plan generally doesn’t accept late enrollees.
Prostheses; and
Treatment of physical complications of the mastectomy, What is COBRA continuation coverage?
including lymphedema.
COBRA continuation coverage is a continuation of Plan
These benefits will be provided subject to the same
deductibles and coinsurance applicable to other medical coverage when it would otherwise end because of a life
and surgical benefits provided under this plan. event. This is also called a “qualifying event.” Specific
qualifying events are listed later in this notice. After a
If you would like more information on WHCRA benefits, qualifying event, COBRA continuation coverage must be
call your plan administrator [insert phone number]. offered to each person who is a “qualified beneficiary.”
You, your spouse, and your dependent children could
become qualified beneficiaries if coverage under the
Plan is lost because of the qualifying event. Under the
COBRA Continuation Coverage Rights
Plan, qualified beneficiaries who elect COBRA
Introduction continuation coverage [must pay] for COBRA
You’re getting this notice because you recently gained continuation coverage.
coverage under a group health plan (the Plan). This
notice has important information about your right to If you’re an employee, you’ll become a qualified
COBRA continuation coverage, which is a temporary beneficiary if you lose your coverage under the Plan
extension of coverage under the Plan. This notice because of the following qualifying events:
explains COBRA continuation coverage, when it may Your hours of employment are reduced, or
become available to you and your family, and what you Your employment ends for any reason other than your
need to do to protect your right to get it. When you gross misconduct.
become eligible for COBRA, you may also become If you’re the spouse of an employee, you’ll become a
eligible for other coverage options that may cost less qualified beneficiary if you lose your coverage under
than COBRA continuation coverage. the Plan because of the following qualifying events:
The right to COBRA continuation coverage was created Your spouse dies;
by a federal law, the Consolidated Omnibus Budget Your spouse’s hours of employment are reduced;
Reconciliation Act of 1985 (COBRA). COBRA
Your spouse’s employment ends for any reason other than
continuation coverage can become available to you and his or her gross misconduct;
other members of your family when group health Your spouse becomes entitled to Medicare benefits (under
coverage would otherwise end. For more information Part A, Part B, or both); or
about your rights and obligations under the Plan and You become divorced or legally separated from your
under federal law, you should review the Plan’s
spouse.
Summary Plan Description or contact the Plan
Administrator.
3
