MSU Human Resources >> Benefits >> Cobra >> COBRA FAQs


Consolidated Omnibus Reconciliation Act (COBRA)

Frequently Asked Questions (FAQs)

Continuation Coverage Rights Under COBRA

This notice contains important information about your right to COBRA continuation coverage of your HEALTH or DENTAL benefits in the MSU’s group health plan (the Plan), which is a temporary extension of coverage under the Plan. This notice generally explains COBRA continuation coverage, when it may become available to you and your family, and what you must do to protect the right to receive it.

A federal law created the right to COBRA continuation coverage. COBRA continuation coverage can become available when you would otherwise lose your group health coverage. It can also become available to other members of your family, who are covered under the Plan, when they would otherwise lose their group health coverage. For additional information about your rights and obligations under the Plan and under federal law, you should review your Health Benefits Brochure or contact:

MSU Human Resources
1407 S. Harrison Rd.
East Lansing, MI 48823
(517) 353-4434 OR 800-353-4434
SolutionsCenter@hr.msu.edu
 

COBRA continuation coverage is a continuation of 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. After a qualifying event, COBRA continuation coverage must be offered to each person who is a “qualified beneficiary.” You, your spouse, and your dependent children could become qualified beneficiaries if coverage under the Plan is lost because of the qualifying event. Under the Plan, qualified beneficiaries who elect COBRA continuation coverage must pay for COBRA continuation coverage.

If you are an employee, you will become a qualified beneficiary if you lose your coverage under the Plan if either one of the following qualifying events happen:

  • Your hours of employment are reduced and you lose coverage under the Plan; or
  • Your employment ends for any reason other than your gross misconduct.

If you are the spouse of an employee, you will become a qualified beneficiary if you lose your coverage under the Plan if any of the following qualifying events happen:

  • Your spouse dies;
  • Your spouse’s hours of employment are reduced causing the loss of coverage under the Plan;
  • Your spouse’s employment ends for any reason other than his or her gross misconduct;
  • Your spouse becomes entitled to Medicare benefits (under Part A, Part B, or both); or
  • You become divorced or legally separated from your spouse.

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

  • The parent-employee dies;
  • The parent-employee’s hours of employment are reduced causing loss of coverage under the Plan;
  • The parent-employee’s employment ends for any reason other than his or her gross misconduct;
  • The parent-employee becomes entitled to Medicare benefits (under 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.”

Sometimes, filing a bankruptcy proceeding under Title 11 of the United States Code can be a qualifying event. If a proceeding in bankruptcy is filed concerning Michigan State University, and that bankruptcy results in the loss of coverage of any retired employee covered under the Plan, the retired employee will become a qualified beneficiary with respect to the bankruptcy. The retired employee’s spouse and dependent children will also become qualified beneficiaries if bankruptcy results in the loss of their coverage under the Plan.

The Plan will offer COBRA continuation coverage to qualified beneficiaries only after the Plan Administrator has been notified of a qualifying event. When the qualifying event is the end of employment or reduction of hours of employment, death of the employee, commencement of a proceeding in bankruptcy with respect to Michigan State University, or the employee becoming entitled to Medicare benefits (under Part A, Part B, or both), Michigan State University must notify the Plan Administrator of the qualifying event.

For other qualifying events (divorce or legal separation of the employee and spouse or a dependent child losing eligibility for coverage as a dependent child), you must notify the Plan Administrator within 60 days of the qualifying event, in writing. Copies of legal documents, such as a copy of the Divorce Decree with custody information (if children are involved) or a signed separation agreement should be included with the written request.

Upon notification of a qualifying event, MSU Human Resources will promptly offer COBRA continuation coverage to each qualified beneficiary. This coverage is crucial as it gives each beneficiary an independent right to elect COBRA continuation coverage. It is worth noting that covered employees can also elect COBRA continuation coverage for their spouse and children.

COBRA continuation coverage is a TEMPORARY continuation of coverage. When the qualifying event is the death of the employee, the employee becoming entitled to Medicare benefits (under 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 a total of 36 months. When the qualifying event is the end of employment or reduction of the employee's hours of employment AND the employee becomes entitled to Medicare benefits, less than 18 months before the qualifying event, COBRA continuation coverage for qualified beneficiaries other than the employee lasts until 36 months after the date of Medicare entitlement. For example, suppose a covered employee becomes entitled to Medicare eight months before the date on which their employment terminates. In that case, COBRA continuation coverage for their spouse and children can last up to 36 months after the date of Medicare entitlement, equal to 28 months after the qualifying event date (36 months minus eight months). Otherwise, when the qualifying event is the end of employment or reduction of the employee’s hours of employment, COBRA continuation coverage generally lasts for only 18 months. There are two ways in which these 18-months of COBRA continuation coverage can be extended (see below).

If you are entitled to choose COBRA coverage, you must be given an election period of at least 60 days (starting when you are given the election notice or the date you would lose coverage; whichever occurs later) to decide whether or not to select continuation coverage.

In certain circumstances, if you or anyone in your family who are covered under the Plan is:

  1. Determined by the Social Security Administration (SSA) to be disabled AND
  2. You notify MSU Human Resources in writing and include copies of the documents from the SSA approving the disability, within 60 days of the determination AND
  3. Prior to the expiration of the 18 months of COBRA continuation coverage,

you and your entire family may be entitled to receive up to an additional 11 months of COBRA continuation coverage, for a total maximum of 29 months. The disability would have to have started before the 60th day of COBRA continuation coverage and must last at least until the end of the 18 months of continuation coverage.

Suppose your family experiences another qualifying event while receiving 18 months of COBRA continuation coverage. In that case, the spouse and dependent children in your family can get up to 18 additional months of COBRA continuation coverage, for a maximum of 36 months, if notice of the second qualifying event is properly given to the Plan. This extension may be available to the spouse and any dependent children receiving continuation coverage if the employee or former employee dies, becomes entitled to Medicare benefits (under Part A, Part B, or both), or gets divorced or legally separated, OR if the dependent child stops being eligible under the Plan as a dependent child, but only if the event would have caused the spouse or dependent child to lose coverage under the Plan had the first qualifying event not occurred. Notification of a second qualifying event must be provided within 60 days of the event in the same manner as the first qualifying event.
In order to protect your family’s rights, you should keep the Plan Administrator informed of any changes in the addresses of family members. For your records, you should also keep a copy of any notices you send to the Plan Administrator.
The COBRA notice should contain all of the information you need related to COBRA premiums you will have to pay, when they are due, and the consequences of late payment or non-payment.
Questions concerning your plan or your COBRA continuation coverage rights should be addressed to MSU Human Resources. For more information about your rights, including COBRA, the Health Insurance Portability and Accountability Act (HIPAA), and other laws affecting group health plans, contact the nearest Regional or District Office of the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) in your area.

 

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