Page 29 - 2024 Employee Benefits Guide

COBRA Continuation of Benefits

When medical, dental & FSA coverage ends
Your medical, dental, and/or flexible spending account benefit coverage
will end on the earliest of the following dates:

› The last day of the calendar month in which you and/or your
dependent are no longer eligible
› The last day of the calendar month in which you are no longer
employed by Texas Mutual. Note: premium deductions for medical
and dental coverage, flexible spending account contributions, as
well as those for elected optional benefits, will be taken for the
full month in which employment ends.

› The date Texas Mutual terminates the benefits as described in this
Resource Guide
Employees & qualified beneficiaries notice requirements

To preserve COBRA rights, covered employees and qualified beneficiaries
are required to provide notice to Texas Mutual Insurance Company of the
following qualifying events:
1. The divorce of the covered employee from his or her spouse;
employee must notify us within 60 days after the latest of 1) the date
this qualifying event occurred, 2) the date that employee would lose
coverage as result of this event, or 3) the date provided in the Summary
Plan Description (SPD) or initial COBRA notice.

2. The beneficiary ceases to be covered under the plan as a dependent
child of a participant; beneficiary must notify us within 60 days after the
latest of 1) the date this qualifying event occurred, 2) the date that the
beneficiary would lose coverage as result of this event, or 3) the date
provided in the SPD or initial COBRA notice.

3. The occurrence of a second qualifying event after a qualified
beneficiary has become entitled to continuation coverage based on
employee termination or reduction in work hours with a maximum
duration of 18 or 29 months; beneficiary must notify us within 60 days
after the latest of 1) the date this qualifying event occurred, 2) the date
that the beneficiary would lose coverage as result of this event, or 3) the
date provided in the SPD or initial COBRA notice.
4. A determination by the Social Security Administration that a qualified
beneficiary, entitled to receive continuation coverage with a maximum of
18 months, is disabled at any time during the first 60 days of
continuation coverage; beneficiary must notify us within 60 days after
the latest of 1) the date of disability determination by the Social Security
Administration, 2) the date this qualifying event occurred, 3) the date the
beneficiary would lose coverage as a result of this event, or 4) the date
provided in the SPD or initial COBRA notice, but in no event later than
the first 18 months of continuation coverage.

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