home
***
CD-ROM
|
disk
|
FTP
|
other
***
search
/
Complete Bookshop
/
CompleteWorkshop.iso
/
health
/
cobra
/
sample.doc
< prev
Wrap
Text File
|
1980-01-01
|
5KB
|
119 lines
SAMPLE STATEMENT TO EMPLOYEES OF FIRMS WITH 20 OR MORE EMPLOYEES
CONSOLIDATED OMNIBUS BUDGET RECONCILIATION ACT ( COBRA )
On April 7, 1986, a new Federal law was enacted [Public Law
99-272, Title X] requiring that most employers sponsoring
group health plans offer employees and their families the
opportunity for a temporary extension of health coverage
(called "continuation coverage") at group rates in certain
instances where coverage under the plan would otherwise end.
This notice is intended to infor you, in a summary fashion,
of your rights and obligations under the continuation coverage
provisions of the new law. [ Both you and your spouse should
take the time to read this notice carefully. ]
If you are an employee of [ Your Company's name ] covered by
[ Your Plan ] you have the right to choose this continuation
coverage if you lose your group health coverage because of a
reduction in your hours of employment or the termination of
your emplpoyment (for reasons other than gross misconduct on
your part).
If you are the spouse of an employee covered by [Your Plan],
you have the right to choose continuation coverage for yourself
if you lose group health coverage under [ Your Plan ] for
ANY of the following four reasons:
(1) The death of your spouse;
(2) A termination of your spouse's employment (for
reasons other than gross misconduct) or reduction
in your spouse's hours of employment;
(3) Divorce or legal separation from your spouse; or
(4) Your spouse becomes eligible for Medicare.
In the case of a dependent child of an employee covered by
[ Your Plan ], he or she has the right to continuation coverage
if group health coverage under [ Your Plan ] is lost for ANY
of the following five reasons:
(1) The death of a parent;
(2) The termination of a parent's employment ( for
reasons other than gross misconduct) or reduction
in a parent's hours of employment with [ Your
Company's name ];
(3) Parents' divorce or legal separation;
(4) A parent becomes eligible for Medicare; or
(5) The dependent ceases to be a "dependent child"
under [ Your Plan ].
In the event of a divorce or legal separation, or a child's
losing dependent coverage status, the employee must notify the
employer within 60 days after the event has occured.(At this
time, the employee/dependents will be notified of their rights
by [ Your Company's name ] to continue coverage, and will be
gien the election for to complete.) Upon termination, reduction
of hours, death, or eligibility for Medicare, the employer must
notify the employee and/or dependents of their rights to continue
coverage and the election be given to you within 14 days after
the event.
After the employee/dependents have been notified of their rights,
the employee has 60 days to choose whether continue coverage
is desired. The election form must be returned to the employer
within these 60 days.
All premiums will be paid to the employer.
If you do not choose continuation coverage, your group health
insurance coverage will end at the date of the qualifying event.
If you do choose continued coverage, [ Your Company's name]
is required to give you coverage which, as of the time coverage
is being provided, is Identical to the coverage provided under
the plan to similarly situated employees or family members.
The new law requires that you be afforded the opportunity to
maintain continuation coverage for 3 years unless you lost group
health insurance coverage because of a termination of employment
or reduction in hours. In that case, the required continuation
coverage period is 18 months. However, the new law also provides
that your continuation coverage may be cut short for ANY of
the following five reasons:
(1) [ Your Company's name ] no longer provides group
health coverage to any of its employees;
(2) The premium for you continuation coverage is not
paid;
(3) You become an employee covered under another group
health plan;
(4) You become eligible for Medicare;
(5) You were divorced from a covered employee and sub-
sequently remarry and are covered under your new
spouse's group health plan.
You do not have to show that you are insurable to choose continuation
coverage. However, under the new law, you may have to pay all
or part of the premium for your continuation coverage. [ The
new law also says that, at the end of the 18 month or 3 year
continuation coverage period, you must be allowed to enroll
in an individual conversion health plan provided under [ Your
Plan ] or a successor plan. ]
If you have any questions about the new law, please contact
[name of company administrator at your company]. Also, if you
or your spouse have changed addresses, please notify us.