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| Policy and Procedure Manual | |
| Section 501 Cobra Notification | |
| Source: Human Resources | |
| Notice of Employee's Rights to Continue Group Health Coverage (Originally issued by the Department of Labor as part of ERISA technical release #86-2) | |
| On April 7, 1986, a 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 heath 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 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 covered by the North Dakota Public Employees Retirement System's (NDPERS) Health Plan, you may have a 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 employment (for reasons other than gross misconduct on your part). | |
| If you are the spouse of an employee covered by the NDPERS Health Plan, you have the right to choose continuation coverage for yourself if you lose group health coverage under the NDPERS Health 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 entitled to Medicare. |
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| In the case of a dependent child of an employee covered by the NDPERS Health Plan, he or she may have the right to continuation coverage if group health coverage under the NDPERS Health Plan is lost for any of the following five reasons: | |
| 1) The death of a parent; 2) A termination of parent's employment (for reasons other than gross misconduct) or reduction in parent's hours of employment with NDSCS. 3) Parent's divorce or legal separation. 4) A parent becomes entitled to Medicare; or 5) The dependent child ceases to be a "dependent child" under the North Dakota Public Employees Retirement System. |
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| Under the law, the employee or a family member has the responsibility to inform NDPERS of a divorce, legal separation, or a child losing dependent status under the NDPERS Health Plan within 60 days of the event or the date in which coverage would end under the Plan, because of event, whichever is later. NDSCS has the responsibility to notify NDPERS of the employee's death, termination, reduction in hours of employment or Medicare entitlement. Similar rights may apply to certain retirees, spouses, and dependent children if our employer commences a bankruptcy proceeding and these individuals loose coverage. | |
| When NDPERS is notified that one of these events has happened, NDPERS will in turn notify you that you have the right to choose continuation coverage. Under the law, you have at least 60 days from the date your would lose coverage because of one of these events described above, or the date notice of your election rights is sent to you, which ever is later, to inform the North Dakota Public Employees Retirement System that you want continuation coverage. | |
| If you do not chose continuation coverage, your group health insurance will end. | |
| If you choose continuation coverage, NDSCS is required to give you coverage which, as the time 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 three years unless you lost group health coverage because of a termination of employment or a reduction in hours. In that case, the required continuation coverage period is for 18 months. This 18 months may be extended to 36 months if other events (such as death, divorce, legal separation, or Medicare entitlement) occur during that 18 month period. | |
| The 18 months may be extended to 29 months if an individual is determined to be disabled (For Social Security disability purposes) and the Plan Administrator is notified of that determination within 60 days. The affected individual must also notify the Plan Administrator within 30 days of any final determination that the individual is no longer disabled. In no event will continuation coverage last beyond 3 years from the date of the event that originally made a qualified beneficiary eligible to elect coverage. | |
| However, the law also provides that your continuation coverage may be terminated for any of the following six reasons: | |
| 1) NDPERS no longer provides group health coverage to any of it's employees; 2) The premium for our continuation coverage is not paid on time; 3) You become covered by another group plan, unless the plan contains any exclusions or limitations with respect to any pre-existing condition you or your covered dependents may have. 4) You become entitled to Medicare; 5) You extend coverage for up to 29 months due to your disability and there has been a final determination that you are no longer disabled. 6) You were divorced from a covered employee and subsequently remarry and are covered under your new spouse's group health plan. |
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| 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. (The 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 the North Dakota Public Employee Retirement System's Health Plan. | |
| The law applies to NDSCS's Health Plan. If you have any questions about the law, please contact the North Dakota Public Employees Retirement System, 400 East Broadway, Suite 505 Box 1214, Bismarck ND 58502 ; at 1-800-803-7377. Also, if you have changed marital status, or you or your spouse have changed addresses, please notify NDSCS at 671-2903. | |
| History: July 1998 | |
