Page 24 - 2016 WFF Guide 1
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This ex tension is av ailable to the spouse M ed icare E x tension for S pouse and E ligible C hild ren
and eligible child ren if, w hile they I f a q ualifying ev ent that is a termination of employment or red uction of hours
and the cov ered former employee are occurs w ithin 1 8 months after the cov ered employee becomes entitled to any part of
purchasing C O B R A cov erage, the former M ed icare, then the max imum cov erage period for the spouse and eligible child ren is
employee: 3 6 months from the d ate the employee became entitled to M ed icare ( but the cov ered
„ d ies, employee’ s max imum cov erage period w ill be 1 8 months) .
„ enrolls in any part of M ed icare, or O ther R ules and R eq uirements

„ gets d iv orced
Same Rights as Active Employees to Add New Dependents. A qualiied beneiciary
The ex tension is also av ailable to an generally has the same rights as similarly situated activ e employees to ad d or d rop
eligible child w hen that child stops being d epend ents, mak e enrollment changes d uring open enrollment, etc. C ontact the P lan
eligible und er the plan as an eligible A d ministrator for more information. S ee also the paragraph below titled , “ C hild ren
child . B orn or P laced for A d option w ith the C ov ered E mployee D uring C O B R A P eriod , ” for
information about how certain child ren acq uired by a cov ered employee purchasing
I n all of these cases, you must mak e COBRA coverage may actually be treated as qualiied beneiciaries themselves. Be sure
sure that the P lan A d ministrator or to promptly notify the P lan A d ministrator or its d esignee if you need to mak e a change
its designee is notiied in writing of to your COBRA coverage. The Plan Administrator or its designee must be notiied
the second q ualifying ev ent w ithin 6 0 in w riting w ithin 3 0 d ays of the d ate you w ish to mak e such a change ( ad d ing or
d ays after ( i) the d ate of the second d ropping d epend ents, for ex ample) . S ee the rules in the box abov e, und er the head ing
q ualifying ev ent or ( ii) the d ate cov erage entitled , “ N otice P roced ures, ” for an ex planation regard ing how your notice should be
is lost, w hichev er occurs last. The plan mad e.
req uires you to follow the proced ures
speciied in the box above, under the C hild ren B orn to or P laced for A d option w ith the C ov ered E mployee D uring C O B R A
head ing entitled “ N otice P roced ures.” P eriod . A child born to, ad opted by, or placed for ad option w ith a cov ered employee
Y our notice must also name the or former employee d uring a period of continuation cov erage is consid ered to be a
second q ualifying ev ent and the d ate qualiied beneiciary provided that, if the covered employee or former employee is
it happened . I f the second q ualifying a qualiied beneiciary, the employee has elected COBRA continuation coverage for
ev ent is a d iv orce or legal separation, himself or herself. The child ’ s C O B R A cov erage begins w hen the child is enrolled in the
your notice must includ e a copy of plan, w hether through special enrollment or open enrollment, and it lasts for as long
the d iv orce d ecree or legal separation as C O B R A cov erage lasts for other family members of the employee. To be enrolled in
agreement. the plan, the child must satisfy the otherw ise applicable plan eligibility req uirements
( for ex ample, age req uirements) . B e sure to promptly notify the P lan A d ministrator
I f these proced ures are not follow ed or or its d esignee if you need to mak e a change to your C O B R A cov erage. The P lan
if the notice is not prov id ed in w riting to Administrator or its designee must be notiied in writing within 30 days of the date
the P lan A d ministrator or its d esignee you w ish to mak e such a change. S ee the rules in the box abov e, und er the head ing
w ithin the req uired 6 0 - d ay period , then entitled , “ N otice P roced ures, ” for an ex planation regard ing how your notice should be
there w ill be no ex tension of C O B R A mad e.
continuation cov erage d ue to the second
q ualifying ev ent.
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