Human Resources - Initial Cobra Notification
Very Important Notice to All State of CT Employees
It is important that all covered individuals take the time to read this notice carefully and be familiar with its contents.
Under federal law, the State of Connecticut is required to offer covered employees and covered family members the opportunity to elect a temporary continuation of health coverage at group rates, when coverage under the plan would otherwise end due to certain qualifying events. This notice is intended to inform you and your covered dependents, if any, in a summary fashion of your options and obligations under the continuation coverage provisions of the law.
Qualifying Events For a Covered Employee - If you are an employee of the State of Connecticut covered by a state-sponsored group health plan, you may have the right to elect this continuation coverage if you lose your group health coverage because of a termination of your employment or a reduction in your hours of employment.
For a Covered Spouse - If you are the spouse of an employee of the State of Connecticut and are covered under his or her state-sponsored group health insurance plan, you may have the right to elect continuation coverage if you lose such group health plan coverage for any of the following reasons:
- A termination of your spouse's employment or a reduction of your spouse's hours of employment with the State of Connecticut;
- The death of your spouse; or
- Divorce or legal separation from your spouse
For Covered Dependent Children - If you are the dependent child of an employee covered by a state-sponsored group health plan, and are covered under the plan, you may have the right to elect continuation coverage if you lose such group health coverage for any of the following reasons:
- A termination of the employee's employment or reduction in the employee's hours of employment with the State of Connecticut,
- The death of the employee;
- Parents divorce or legal separation; or
- You cease to be a "dependent child" under the group health plan.
If you are a child born or placed for adoption with a covered employee during the continuation coverage period, you may also elect continuation coverage.
Notification Requirements for Covered Employees, Spouses, and Dependents
Under the law, the covered employee, spouse, or other family member has the responsibility to inform the State of Connecticut of a divorce, legal separation, or a child losing dependent status under the state sponsored group health plan. This notification must be made within 31 days from the later of the date of the event or the date on which coverage would be lost because of the event. This notification must be made to your Human Resources Department. Check the dependent eligibility rules of your plan carefully to determine when a child loses dependent status under the plan. If this notification is not completed in a timely manner, rights to continuation coverage may be forfeited. Your agency has the responsibility to notify the COBRA Administrator of your termination of employment, reduction in hours, or death.
Once your agency is notified that a qualifying event has occurred, it will in turn notify covered individuals (also known as qualified beneficiaries) of their right to elect continuation coverage. Each qualified beneficiary has an independent election right and will have 60 days from the later of the date coverage is lost under the group health plan or from the date of notification to elect continuation coverage. If a qualified beneficiary does not elect continuation coverage within this election period the right to elect continuation coverage will end.
If a qualified beneficiary elects continuation coverage and pays the applicable premium, the State of Connecticut is required to provide the qualified beneficiary with coverage that is identical to the coverage provided under the plan to similarly situated employees and/or covered dependents. If coverage is modified for similarly situated active employees, then continuation coverage may be similarly changed and/or modified.
Length of Continuation Coverage
18 Months - If the event causing the loss of coverage is a termination of employment or a reduction in employment hours, the qualified beneficiary will have the opportunity to continue coverage for 18 months from the date of the qualifying event.
Disability Extension: The 18 months of continuation coverage can be extended to 29 months if the Social Security Administration determines that a qualified beneficiary was disabled during the first 60 days of continuation coverage according to Title II or XV of the Social Security Act. It is the qualified beneficiary’s responsibility to obtain this disability determination from the Social Security Administration and to provide a copy of the determination letter to the COBRA Administrator within 60 days of the date of determination and before the original 18 months expire. It is also the qualified beneficiary’s responsibility to notify the COBRA Administrator within 30 days of a final determination by Social Security that the qualified beneficiary is no longer disabled.
Secondary Events: Another extension of the 18 month continuation period can occur, if during the 18 months of continuation coverage, a second qualifying event takes place (divorce, legal separation, death, Medicare entitlement, or a dependent child ceasing to be a dependent). If a second qualifying event does take place, then the 18 months of continuation coverage can be extended to 36 months from the date of the original qualifying event date. If a second event occurs, it is the qualified beneficiary’s responsibility to notify the COBRA Administrator. In no event, however, will continuation coverage last beyond three years from the date of the event that originally made the qualified beneficiary eligible for continuation coverage.
36 Months - If the original event causing the loss of coverage was the death of the employee, divorce, legal separation, or a dependent child losing such status under the state-sponsored group health plan, then each qualified beneficiary will have the opportunity to elect continuation coverage for 36 months from the date of the qualifying event.
Eligibility Premiums, And Potential Conversion Rights
A qualified beneficiary does not have to show that he or she is insurable to elect continuation coverage. You must be covered under the plan at the time of the qualifying event to be able to elect continuation coverage. The State, through its COBRA Administrator, reserves the right to verify eligibility status and terminate continuation coverage retroactively if an individual is determined to be ineligible or if there has been a material misrepresentation of the facts. A qualified beneficiary will have to pay all of the applicable premium plus a 2% administration charge for continuation coverage. The premium may change in the future when the premium for the active employee plan is changed. There is a grace period of 30 days for the regularly scheduled monthly premiums. At the end of the continuation coverage period, a qualified beneficiary must be allowed to enroll in an individual conversion plan if one is available.
Notification of Address Change - To ensure that all covered individuals receive information properly and efficiently, it is important that you notify your personnel or payroll office of any address change as soon as possible. Failure on your part to do so may result in delayed notification or a loss of continuation coverage options.
Termination of Continuation Coverage - The law allows continuation coverage to end prior to the maximum continuation period for any of the following reasons:
- 1. The State of Connecticut ceases to provide any group health plan to any of its employees;
- Any required premium for continuation coverage is not paid in a timely manner;
- A qualified beneficiary becomes covered under another group health plan that does not contain any exclusion or limitation with respect to any preexisting condition of such beneficiary;
- A qualified beneficiary who extended continuation coverage due to a disability is determined by Social Security to be no longer disabled;
- A qualified beneficiary notifies the COBRA Administrator that he or she wants to cancel continuation coverage.
Any Questions? - If any covered individual does not understand any part of this summary notice or has questions regarding the information or his or her obligations, please contact the Human Resources Department.