COBRA - Continuation of Health Coverage

Eligibility for COBRA Continuation

COBRA continuation coverage may be available to employees and their eligible dependents when group health coverage would otherwise be lost due to any of the following qualifying events:

• Voluntary or involuntary termination of employment (other than for gross misconduct)

• Reduction in work hours resulting in loss of benefits eligibility

• Divorce or legal separation from the covered employee

• Death of the covered employee

• Covered dependent no longer meeting eligibility requirements (e.g., aging out)

• The covered employee becoming entitled to Medicare

Notification and Enrollment

In the event of a qualifying event, Paramus Public Schools, or its designated plan administrator, will provide the eligible individual with a written notice of their COBRA rights. This notice will include instructions on how to elect continuation coverage, applicable deadlines, and information about the premium payment process.

Eligible individuals must elect COBRA continuation coverage within 60 days of the later of:

1. The date coverage would otherwise end due to the qualifying event, or

2. The date of the COBRA election notice.

Coverage Period and Benefits

COBRA continuation coverage is typically available for a maximum of:

• 18 months for loss of coverage due to termination of employment or reduction in hours.

• 36 months for other qualifying events, such as divorce, death of the employee, or loss of dependent eligibility.

In certain cases, the 18-month coverage period may be extended up to 29 or 36 months under specific conditions (e.g., disability as determined by the Social Security Administration).

Coverage under COBRA will mirror the benefits available under the group health plan at the time of the qualifying event and may include medical, dental, and vision coverage, depending on what was elected prior to the event.

Premium Payments

Individuals who elect COBRA continuation coverage are responsible for the full cost of the premium, including any portion previously paid by the District, plus a two percent administrative fee. Timely payment of premiums is required to maintain coverage.

Termination of COBRA Coverage

COBRA coverage may terminate before the maximum coverage period if:

• Premiums are not paid on time.

• The individual becomes covered under another group health plan.

• The individual becomes entitled to Medicare after electing COBRA.

• The District no longer provides group health coverage to any employees.