Page 55 - Team Member Handbook Aug 2020.docx

POLICY: COBRA Policy #37
CREATION DATE: September 2015
REVISION DATE:

EFFECTIVE DATE: January 2016
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Under a federal law called the Comprehensive Omnibus Budget Reconciliation Act of 1986
(COBRA), most employers sponsoring group health plans must offer an extension of health
coverage (called ''continuation coverage'') to their team members at group rates under certain
circumstances when coverage would otherwise end. We at Jack & Jill Children’s Center abide
by the requirements of COBRA. The circumstances which qualify for an extension of coverage
are called ''qualifying events.'' Below is a list of qualifying events for yourself, your spouse, and
your dependent children.

Qualifying Events for Yourself:

 A reduction in hours worked makes you ineligible for coverage.
 Termination of employment for reasons other than gross misconduct on
your part

Qualifying Events for Your Spouse:

 Death of team member (yourself).
 Termination of your employment for reasons other than gross misconduct.
 A reduction in team member's hours worked.
 Divorce or legal separation.
 Team member becomes eligible for Medicare.

Qualifying Events for A Dependent Child:

 Death of team member-parent.
 Termination of parent's employment for reasons other than gross misconduct.
 A reduction in parent's hours worked.
 Parent's divorce or legal separation.
 The dependent ceases to be a dependent child under the health plan.

You or a member of your family must inform the Human Resources Department of a divorce,
legal separation, or a child losing dependent status within 60 days of the event. Jack & Jill
Children’s Center has the responsibility for notifying you or your family of continuation options
within 14 days of your death, termination of employment, reduction in hours, or Medicare
entitlement. If you do elect continuation coverage, the insurance company is required to give
you coverage which, as of the time coverage is being provided, is identical to the coverage
provided under the plan to similarly situated team members or family members for whom a
qualifying event has not occurred.

COBRA requires coverage be continued for a maximum of 18 months if you lose group coverage
due to termination of employment or a reduction in hours. A second qualifying event, such as
divorce or a dependent child losing dependent status may occur to your dependents while
coverage is already being continued. If so, the continued dependents will be eligible for