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BENEFITS

COBRA Information

The basics about COBRA offered and who is eligible; how to enroll in COBRA; how to make changes to your COBRA; and what happens with your COBRA when you leave Tulane.

 

What is COBRA and who is covered?

Consolidated Omnibus Budget Reconciliation Act (COBRA) continuation coverage is a continuation of your current Plan coverage when coverage would otherwise end because of a life event known as a "qualifying event." Specific qualifying events are listed later in this notice. COBRA continuation coverage must be offered to each person who is a "qualified beneficiary." A qualified beneficiary is someone who will lose coverage under the Plan because of a qualifying event. Depending on the type of qualifying event, employees, spouses of employees, and covered dependent children may be qualified beneficiaries. Under the Plan, qualified beneficiaries who elect COBRA continuation coverage must pay for COBRA continuation coverage.

Employees:

You will become a qualified beneficiary if you will lose your coverage under the Plan because one of the following qualifying events happens:

  • Your hours of employment are reduced, or
  • Your employment ends for any reason other than your gross misconduct, or
  • Your leave ends under the Family and Medical Leave Act, and you do not return to work.

Spouse of an employee:

You will become a qualified beneficiary if you will lose your coverage under the Plan because any of the following qualifying events happens:

  • Your spouse dies;
  • Your spouse's hours of employment are reduced;
  • Your spouse's employment ends for any reason other than his or her gross misconduct;
  • Your spouse becomes enrolled in Medicare (Part A, Part B, or both); or
  • You become divorced or legally separated from your spouse.

Dependent children of an employee:

Your dependent children will become qualified beneficiaries if they will lose coverage under the Plan because any of the following qualifying events happens:

  • The parent-employee dies;
  • The parent-employee's hours of employment are reduced;
  • The parent-employee's employment ends for any reason other than his or her gross
    misconduct;
  • The parent-employee becomes enrolled in Medicare (Part A, Part B, or both);
  • The parents become divorced or legally separated; or
  • The child stops being eligible for coverage under the plan as a "dependent child," (e.g., age, marriage or loss of student status).

 

Notice Requirements

The Plan will offer COBRA continuation coverage to qualified beneficiaries only after the Plan  Administrator has been notified that a qualifying event has occurred. For some qualifying events (divorce or legal separation of the employee and spouse, or a dependent child losing eligibility for coverage), you must notify the Plan Administrator. The Plan requires you to notify the Plan Administrator within 60 days after the qualifying event occurs.  If the notice is not received within 60 days, the dependent will not be entitled to choose continuation coverage. You must send this notice to: Tulane University Workforce Management Organization, Attention: Benefits, 200 Broadway, Suite 120, New Orleans, LA 70118.   

You are not required to notify the Plan Administrator when the qualifying event is the end of employment, a reduction of hours of employment, or the death of the employee. For these qualifying events, the Plan Administrator will send a written notice within 30 days following the date coverage ends to offer COBRA continuation coverage to qualified beneficiaries.

If you do not choose continuation coverage within the 60-day election period, your group health coverage will end as of the date of the qualifying event.

 

What are the enrollment procedures for a dependent who has aged out of the plan or former spouse?

Contact a Benefit Specialist regarding your qualifying event.  If the qualifying event is for a dependent or a former spouse, complete a Change in Status Form indicating the reason for your request (i.e. child aged out of plan or no longer married to spouse). 

 

What are the enrollment procedures if I leave Tulane University?   

Your health and dental insurance coverage will terminate on the last day of your employment.  If you choose to continue your health and/or dental insurance coverage through the university, you will have 60 days to make your COBRA election.  You will be receiving a package of information on your COBRA rights and information on making a COBRA election from Crosby Benefits, our COBRA administrator. 

To find out more about your COBRA rights, please contact Crosby directly:

Crosby Benefit Systems
www.crosbybenefits.com
1.800.462.2235

With any other questions, please contact Work Force Management Organization.

The COBRA Administrator will assign the individual an account number needed to access any information regarding the individuals account.  The COBRA Administrator will also mail out an information regarding your COBRA rights, how to make your election on line, and your payment options.  If you have any questions, contact the COBRA Administrator just remember to have your account number handy when calling.  

Your COBRA notification is not set up until you are no longer  active on our payroll system. We will set up your COBRA account with Crosby Benefits COBRA Services as soon as we receive the termination paperwork from the department. You should receive the notice within 15 days of leaving the University.  Below is the contact information for the third party administrator who handles COBRA for the university. You will need your account number when contacting ADP. Your account number is not yet available. If you have not received in the mail by middle of the month following your date of termination, contact Gerallynn Wesley , Benefits Specialist.

 

How long will COBRA coverage continue?

Once the Plan Administrator receives notice that a qualifying event has occurred, COBRA continuation coverage will be offered to each of the qualified beneficiaries. For each qualified beneficiary who elects COBRA continuation coverage, COBRA continuation coverage will begin on the date of the qualifying event if the initial premium due is paid to the Plan Administrator on or before the 45th day after electing coverage. If timely monthly payments of premium are made coverage will continue.

COBRA continuation coverage is a temporary continuation of coverage. When the qualifying event is the death of the employee, enrollment of the employee in Medicare (part A, Part B, or both), your divorce or legal separation, or a dependent child losing eligibility as a dependent child, COBRA continuation coverage lasts for up to 36 months for the spouse and dependent children.

When the qualifying event is the end of employment or reduction of the employee's hours of employment, COBRA continuation coverage lasts for up to 18 months. There are two ways in which this 18-month period of COBRA continuation coverage can be extended due to  Disability or Second Qualifying Event.

 

Disability extension of the 18-month period of continuation coverage

If you or anyone in your family covered under the Plan is determined by the Social Security Administration to be disabled at any time during the first 60 days of COBRA continuation coverage and you notify the Plan Administrator in a timely fashion, you and your entire family can receive up to an additional 11 months of COBRA continuation coverage, for a total maximum of 29 months. You must make sure that the Plan Administrator is notified in writing with a copy of the Social Security Administration's determination within 60 days of the date of the determination and before the end of the 18-month period of COBRA continuation coverage.

This notice should be sent to: Tulane University Workforce Management Organization, Attention: Benefits, 200 Broadway, Suite 120, New Orleans, LA 70118.

 

Second qualifying event extension of the 18-month period of continuation coverage

If your family experiences another qualifying event while receiving COBRA continuation coverage, the spouse and dependent children in your family can get additional months of COBRA continuation coverage, up to a maximum of 36 months. This extension is available to the spouse and dependent children if the former employee dies, or gets divorced or legally separated. The extension is also available to a dependent child when that child stops being eligible under the Plan as a dependent child. In all of these cases, you must make sure that the Plan Administrator is notified in writing of the second qualifying event within 60 days of the second qualifying event.

This notice must be sent to: Tulane University Workforce Management Organization, Attention: Benefits, 200 Broadway, Suite 120, New Orleans, LA 70118.

 

If you have questions...


If you have questions about your COBRA continuation coverage, you should contact Tulane University Human Resources, Benefits Section, or you may contact the nearest Regional or District Office of the U.S. Department of Labor's Employee Benefits Security Administration (EBSA). Addresses and phone numbers of Regional and District EBSA Offices are available through EBSA's website at www.dol.gov/ebsa.

Keep your plan informed of address changes

In order to protect your family's rights, you should keep the Plan Administrator informed of any changes in the addresses of family members. You should also keep a copy, for your records, of any notices you send to the Plan Administrator.

 

Informing Tulane University to request a COBRA notice

Following is a form for your use in notifying Tulane University Workforce Management Organization that you are requesting additional information about COBRA because you had a qualifying event in the last 60 days that may effect the eligibility for or the duration of COBRA. If you have questions regarding the use of this form, please contact the Tulane University Workforce Management Organization, Benefits Section at (504) 865-5280.



 
 

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