Page 37 - 2019 Sharks Benefits V6.1

About the COBRA Law

COBRA refers to a federal law applicable to most employers who sponsor group health insurance plans
for their employees and dependents. For COBRA purposes, a group health plan includes any major
medical plan, dental plan, vision plan, health FSA, or any other employer-sponsored group plan that
provides medical care.

The law requires that employees and certain dependents (spouse and dependent children) who lose
coverage under a group health plan must be given the opportunity to continue coverage on a temporary
basis. The maximum length of time coverage may be continued depends upon the reason coverage is
lost. An employee, spouse and/or dependent child who loses coverage as a result of qualifying event
becomes a “qualified beneficiary.”

There may be other coverage options for you and your family. When key parts of the health care law
take effect in 2014, you’ll be able to buy coverage through the Health Insurance Marketplace, also
known as the Exchange. In the Marketplace, you could be eligible for a new kind of tax credit that
lowers your monthly premiums right away, and you can see what your premium, deductibles, and out-
of-pocket costs will be before you make a decision to enroll. Being eligible for COBRA does not limit
your eligibility for coverage for a tax credit through the Marketplace. Additionally, you may qualify for a
special enrollment opportunity for another group health plan for which you are eligible (such as a
spouse’s plan), even if the plan generally does not accept late enrollees, if you request enrollment
within 30 days.

COBRA Qualifying Events

If you are an employee, you will become a qualified beneficiary if you will lose your coverage under
the Plan because either one of the following qualifying events happens:

(1) Your hours of employment are reduced, or
(2) Your employment ends for any reason other than your gross misconduct.

If you are the spouse of an employee covered by the Plan, you will become a qualified beneficiary if
you lose group health coverage under the Plan for any of the following reasons:

(1) Your spouse dies;
(2) Your spouse’s hours of employment are reduced;
(3) Your spouse’s employment ends for any reason other than his or her gross misconduct;
(4) Your spouse becomes entitled to Medicare benefits (Part A, Part B or both); or
(5) You become divorced or legally separated from your spouse.

In the case of a dependent child of an employee covered by the Plan, he or she will become a qualified
beneficiary if he or she loses group health coverage under the Plan for any of the following reasons:

(1) The parent-employee dies;
(2) The parent-employee’s hours of employment are reduced;
(3) The parent-employee’s employment ends for any reason other than his or her gross misconduct;
(4) The parent-employee becomes entitled to Medicare benefits (Part A, Part B or both);
(5) Parents become divorced or legally separated; or

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