COBRA

As a Lafayette College employee, you and your family have the opportunity, under conditions specified by Federal law, to effect a temporary extension of health insurance coverage, at your expense, in certain instances where coverage under the plan would otherwise end.

This notice is intended to inform you of your rights and obligations under the continuation of coverage provisions. Both you and your spouse should read this notice thoroughly. As an employee, if you are covered by the College’s group medical insurance, you have the right to choose the continuation of coverage if you lose your group coverage because of a reduction in your work schedule or the termination of your employment (except in cases of gross misconduct).

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

  • The death of your spouse, the eligible employee
  • Termination of your spouse’s employment (for reasons other than gross misconduct) or a reduction in your spouse’s hours of employment
  • Divorce or legal separation from your spouse
  • Your spouse becomes entitled to Medicare

Dependent children of employees also have the right to continuation of coverage if group health coverage is lost for any of the following five reasons:

  • The death of a parent, the eligible employee
  • The termination of the parent’s employment (for reasons other than gross misconduct) or a reduction in a parent’s hours of employment
  • Parents’ divorce or legal separation
  • A parent becomes entitled to Medicare
  • The dependent ceases to be a “dependent child” under the terms of the contract

If you, as employee or family member, wish to use the continuation of coverage you have the responsibility to inform the College’s benefits administrator, in the Human Resources Office, about a divorce, legal separation, Medicare entitlement, or a child’s loss of dependent status under the plan.

When Human Resources learns that one of the events described above has occurred, you will be notified about how to exercise your rights to the continuation of coverage. You have at least 60 days from the date you would lose coverage to inform Human Resources that you want to continue your medical insurance coverage.

If you do not choose the continuation of coverage, your group health insurance coverage will end.

If you choose the continuation of coverage, it will be identical to the coverage provided under the group plan to similarly situated employees or family members. While you do not have to prove that you are medically insurable to continue your coverage, you must pay all of the premiums for your continuation of coverage, but they are calculated at group rates (plus a two percent administration charge).

You will be afforded the opportunity to maintain the continuation of coverage for three years unless you lost your group health coverage because of a termination of employment or a reduction in hours. In that case, the continuation coverage period is 18 months. The 18 months may be extended to 29 months if a qualified beneficiary is determined by the Social Security Administration to be disabled (for Social Security disability purposes) at any time during the first 60 days of COBRA coverage. This 11-month extension is available to all individuals who are qualified beneficiaries due to termination or reduction in hours of employment. To benefit from this extension, a qualified beneficiary must notify the plan administrator within 30 days of any final determination that the individual is no longer disabled.

However, your continuation of coverage may be cut short for any of the following reasons.

  • The College no longer provides group health coverage to any of its employees
  • The premium for your continuation coverage is not paid
  • You become covered under any other group health plan (as an employee or otherwise)
  • You become entitled to Medicare

If you have any questions about this continuation procedure please contact the Office of Human Resources. Also, please remember that you must notify us if your marital status changes or you or your spouse move to a new address.