COBRA

COBRA

Eligibility:

• • You have a right to choose continuation coverage if you lose your benefits because of a reduction in your hours of employment, termination of your employment, or retirement.

  • This applies to your dependents, as well.  

  • If you divorce, your spouse is eligible for continuation of benefits through COBRA.  

  • If your dependent child ages out of insurance coverage, your child is eligible for continuation of benefits through COBRA.

  • You are afforded the opportunity to maintain continuation coverage for 3 YEARS.

  • A notice will be sent to your home by Titan, a Third Party Administrator.  The notice will provide details and pricing.  

  • This applies to Dental and Vision insurances. There is no option to continue Legal insurance. 

NOTIFICATION OF RIGHTS UNDER “COBRA” (Consolidated Omnibus Budget Reconciliation Act)

On April 7, 1986, a new Federal law was enacted [Public Law 99-272, Title X] requiring that employers sponsoring group health plans and welfare funds providing supplemental medical benefits offer employees and their families the opportunity for a temporary extension of health and welfare coverage (called “continuation coverage”) at group rates in certain instances where coverage under the plan would otherwise end. This notice is intended to inform you, in 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 the Valhalla Public Schools covered by the Valhalla Teachers’ Association Fund, you have a right to choose continuation coverage if you lose your benefits because of a reduction in your hours of employment or the termination of your employment (for reasons other than gross misconduct on your part).

If you are the SPOUSE of an employee covered by the Valhalla Teachers’ Association Benefit Fund, you have the right to choose continuation coverage for yourself if you lose the supplemental benefits provided by the Valhalla Teachers’ Association Benefit Fund 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 became eligible for Medicare.

In the case of a dependent child of an employee covered by the Valhalla Teachers’ Benefit Fund, he/she has the right to choose continuation coverage in the coverage under the Valhalla Teachers’ Association Benefit Fund is lost FOR ANY OF THE FOLLOWING REASONS: 1) The death of a parent; 2) The termination of a parent’s employment (for reasons other than gross misconduct) or a reduction in a parent’s hours of employment with Valhalla Public Schools; 3) Parents’ divorce or legal separation; 4) A parent became eligible for Medicare; or 5) The dependent ceases to be a “dependent child” under the Valhalla Teachers’ Association Benefit Fund. Under the law, the employee or a family member has the responsibility to inform the plan administrator of the Benefit Fund, of a divorce, legal separation, or a child losing dependent status. Valhalla Public Schools has the responsibility to notify the plan administrator of the Benefit Fund of the employee’s death, termination of employment or reduction in hours, or Medicare eligibility.

When the plan administrator is notified that one of these events has happened, he/she will, in turn, notify the appropriate Third Party Administrators (TPA).  They will notify you that you have the right to choose continuation coverage. Under the new law, you have at least 60 days from the date you would lose coverage because of one of the events described above, to inform the TPA that you want continuation coverage.  They will then contact the plan administrator.

If you DO CHOOSE continuation coverage of the supplemental benefits provided by the Valhalla Teachers’ Association Benefit Fund, the Welfare Fund 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 members or family members. The new law requires that you be afforded the opportunity to maintain continuation coverage for 3 YEARS unless you lost coverage because of a termination of employment or a reduction in hours. In that case, the required continuation coverage period is 18 MONTHS (Up to 29 months if disabled at the time of the qualifying event.). However, the new law also provides that your continuation coverage may be cut short for any of the following reasons: 1) The premium of your continuation coverage IS NOT PAID; 2) You were divorced from a covered employee and subsequently 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 law, you may have to pay all or part of the premium for your continuation coverage.

This law applies to the Valhalla Teachers’ Benefit Fund beginning on January 1, 1989. If you have any questions about the law, please contact the Plan Administrator, VTA Benefit Fund, 300 Columbus Ave., Valhalla, New York 10595. Also, if you have changed marital status, or you or your spouse have changed your address, please notify the Fund at the above address.