Other Important Information

COBRA Eligibility

You and your covered spouse and dependents (referred to as “qualified beneficiaries” under COBRA) may purchase continued coverage for up to 18 months if you lose coverage under the plan due to:

• Termination of your employment (for reasons other than gross misconduct), or
• A reduction of your work hours.

Preexisting Condition Limitation

Once you have elected COBRA, if you or your covered spouse or dependent become covered under another group plan and are affected by a preexisting condition limitation under that plan, COBRA coverage may continue until you have satisfied the preexisting condition limitations under your new plan (at which point your COBRA coverage may be terminated).

In Case of Disability

You and your covered spouse and dependents may be eligible for a total of 29 months of continued coverage if you or a covered family member is determined by the Social Security Administration to be disabled (for Social Security disability purposes) at the time of your termination of employment or within 60 days of the qualifying event. This 11-month extension is available to all family members who are qualified beneficiaries due to termination or reduction in hours of employment, including those who are not disabled. You must notify the School District’s Employee Benefits Office in writing that you or a covered family member is disabled within the initial 18-month coverage period and within 60 days of Social Security’s disability determination.

The disability would have to have started at some time before the 60th day of COBRA continuation coverage and must last at least until the end of the 18-month period of continuation coverage. The qualified beneficiary must provide the written determination of disability from the Social Security Administration to the Employee Benefits Office within 60 days of the latest of:

• the date of the disability determination by the Social Security Administration,
• the date of the qualifying event, or
• the benefit determination date.

You will be required to pay up to 150% of the group rate during the 11-month extension.

Your verbal notice is not binding until confirmed in writing and until a copy of the determination from the Social Security Administration is provided to the Employee Benefits Office.

If during continued coverage, the Social Security Administration determines that you or the family member is no longer disabled, you or your family member must inform the School District’s Employee Benefits Office of this redetermination within 30 days of the date it is made. If another qualifying event occurs within the 29-month continuation period, then the maximum continued coverage period is 36 months after the termination of employment or reduction in hours.