COBRA - Employees

When an employee leaves the company or is terminated, you have the responsibility of notifying Consociate Dansig of the employee's death, termination of employment, reduction in work hours, or Medicare entitlement.

If you are the employee covered by the Associated General Contractors (AGC) Group Health Benefit Fund, you have the right to choose continuation coverage for yourself if you lose your group health coverage because of a reduction in your hours of employment or the termination of your employment for any reason other than gross misconduct.

If you are the spouse of the employee, you have the right to choose continuation coverage for yourself if you lose group health coverage under the AGC Plan for any of the following reasons:

The employee reduces hours of employment or terminates employment for any reason except gross misconduct. The employee dies. You and the employee divorce or legally separate. The employee becomes entitled to Medicare.

Your child has the right to choose continuation coverage if he or she loses group health coverage under the AGC Plan for any of the following reasons:

The employee reduces hours of employment or terminates employment for any reason except gross misconduct. The employee dies. The employee divorces or legally separates from the spouse. The employee becomes entitled to Medicare. The child ceases to be a dependent child, as defined by AGC.

Under COBRA, you have the responsibility to inform Consociate Dansig of a divorce, legal separation, or a child losing dependency status under the AGC Health Plan within 60 days of the date coverage would be lost because of one of these events. Your employer has the responsibility of notifying Consociate Dansig of the employee's death, termination of employment, reduction in work hours, or Medicare entitlement.

When Consociate Dansig is notified that one of these events has happened, we will in turn notify you that you have the right to choose continuation coverage. Under the law, you have at least 60 days to inform Consociate Dansig that you want continuation coverage. If you do not choose continuation coverage within the 60-day period, your group health coverage will end the day of termination.

If you choose continuation coverage, we will give you coverage, which, as of the time is being provided, is identical to the coverage we provide active employees and their family members. The maximum continuation coverage period is 18 months. If, however, you are disabled within 60 days of employment termination or reduction in hours as defined by Social Security, you will be entitled to 29 months of continuation coverage; provided you notify Consociate Dansig of Social Security's disability determination within 60 days of the determination and 18 months of the event. The 18-month period may also be extended if, while covered under the plan, other events occur (i.e. divorce, legal separation, employee's death, employee's entitlement to Medicare).

COBRA also provides that your continuation coverage may be cut short for any of the following reasons:

We no longer provide group health coverage to any employee. You fail to pay your premium for continuation coverage. You become covered under another employer's group health plan that does not limit or exclude coverage for any pre-existing medical condition. You become entitled to Medicare.

You do not have to show that you are insurable to choose continuation coverage. However, you must pay 102 percent of the premium for your continuation coverage. If your coverage is extended from 18 to 29 months for disability, you must pay 150 percent of the premium beginning with the 19th month of continuation coverage. The cost of group health coverage periodically changes. If you elect continuation coverage, we will notify you of any changes in the cost.

The initial payment for continuation coverage is due 45 days from the date of your election. Thereafter, you must pay for coverage on a monthly basis for which you have a grace period of 30 days.

Link to: http://www.dol.gov/pwba/pubs/cobrafs.htm