Welfare Summary Plan Description

4.2 NOTICES REGARDING DISABILITY DURING COBRA COVERAGE

In order to qualify for a possible extension of COBRA coverage following an Eligible Employee's termination of employment or reduction in hours based on a determination of disability by the Social Security Administration, you must notify the Administrative Office within 60 days after the latest of:

  • the date of the Social Security Administration's disability determination,
  • the date of the covered employee's termination of employment or reduction of hours, or
  • the date on which the qualified beneficiary loses (or would lose) coverage as a result of his or her termination of employment or reduction of hours.

You must provide written notice of disability (including the nature of the disability) and a copy of the Social Security Administration determination of disability within the 60-day time period specified above to the Administrative Office (contact information in the Quick Reference Table at the front of this booklet). You must mail your written notice and supporting documentation, and your envelope must be postmarked by no later than the 60-day deadline specified above. You may also send your written notice and supporting documentation by overnight courier (such as UPS), and your delivery envelope must show a delivery order date within the 60-day deadline specified above. Other forms of notice, including hand delivery, fax, oral notice (including telephone notice) and electronic notice (including email notice) are not acceptable. If your written notice and Social Security Administration determination of disability are not mailed or sent by courier to the Administrative Office within the 60-day period specified above, then there will be no disability extension of COBRA coverage.