Welfare Summary Plan Description

14.4 QUALIFYING EVENTS

If eligibility for health benefits terminates due to either of the Qualifying Events shown below, an Eligible Employee and his or her Dependents may elect COBRA for a maximum of 18 months following the date your coverage is lost:

  • Your layoff or reduction in work hours (including reduction due to strike, lockout, or labor dispute); or
  • Termination of your employment for any reason other than gross misconduct.

If Social Security determines that you or one of your eligible Dependents are totally disabled at any time before or during the first 60 days of COBRA coverage, the disabled person and family may extend COBRA coverage an additional 11 months beyond the original 18, to a maximum of 29 months (or if earlier, the first of the month that is 30 days after Social Security determines the individual is no longer disabled.) In order to qualify for this disability COBRA extension, you must report the Social Security disability determination to the Administrative Office before the initial 18 months of COBRA expires and within 60 days after the date of the Social Security determination.

The Spouse and eligible Dependent children of an Eligible Employee or Retired Participant may elect COBRA for a maximum of 36 months from the date of loss of coverage due to any of the following Qualifying Events:

  • Death of the Eligible Employee or Retired Participant;
  • Divorce from the Eligible Employee or Retired Participant;
  • Dependent child ceases to meet the Plan's definition of "Dependent."

In most circumstances, withdrawal of your Employer from the Plan is not a Qualifying Event.

Second Qualifying Event
If a second Qualifying Event occurs during the first 18 months of COBRA coverage, COBRA may be extended for Dependent Qualified Beneficiaries for up to 36 months from the date of loss of coverage due to the first Qualifying Event. The first Qualifying Event must be, and the second Qualifying Event cannot be, termination of employment or reduction in hours.

If an Eligible Employee experiences a Qualifying Event because of a termination of employment or reduction in hours after they became entitled to Medicare, their Dependents will be allowed to continue COBRA coverage until the later of:

  • 18 months from the date of loss of coverage due to the Qualifying Event, or
  • 36 months from the date the Eligible Employee became entitled to Medicare.