COBRA Continuation Coverage

Coverage for the retiree, spouse or dependent children terminates on the earliest of the dates described in Termination Of Coverage. However, coverage for the retiree’s covered spouse or covered dependent children can continue beyond the applicable termination date if the spouse or dependent children qualify for, and properly elect, COBRA Continuation Coverage. COBRA Continuation Coverage is not available to individuals who become entitled to (covered by) Medicare after the date of the COBRA election. COBRA is available on a month-to-month basis at the covered spouse’s or covered dependent children’s expense.

A federal law, the Consolidated Omnibus Budget Reconciliation Act, COBRA, Public Law 99-272,Title X and later amendments, requires group health plans to offer the retiree’s covered spouse and covered dependent children the opportunity for a temporary extension of health coverage (called “COBRA Continuation Coverage”) on a self-pay basis under certain circumstances called “qualifying events” where coverage would otherwise end. Covered individuals who are entitled to elect COBRA Continuation Coverage are called “qualified beneficiaries.”

A covered spouse may elect COBRA Continuation Coverage for all covered dependent children or each affected dependent child may decide independently whether to elect COBRA Continuation Coverage. If the covered spouse elects COBRA Continuation Coverage for himself or herself, he or she automatically elects COBRA Continuation Coverage for his or her covered dependent children, unless stated otherwise. If the covered spouse or covered dependent children do not elect COBRA Continuation Coverage in a timely manner, plan coverage will end and may not be reinstated.

If the covered spouse or covered dependent children elect COBRA Continuation Coverage, they are entitled to the coverage provided under the plan to similarly situated spouses or dependent children. If the covered spouse or covered dependent children are covered by another plan or Medicare, the benefits of this plan are determined after the benefits of the other plan or Medicare. Life insurance benefits are not available under COBRA.

This information is intended to inform the retiree’s spouse and dependent children in a summary fashion of all rights and obligations under the COBRA Continuation Coverage provision of the law.

Qualified Beneficiaries

Qualified beneficiaries include individuals who, on the day before a qualifying event, are covered under this plan either as the covered spouse of a retiree or a covered dependent child of a retiree. Family members of a qualified beneficiary who are newly acquired during a period of COBRA Continuation Coverage may be enrolled under the plan’s enrollment provisions, but will not be considered qualified beneficiaries.

Nonresident aliens under Treasury Regulation §54.4980B-3, and their dependents, are not qualified beneficiaries.

An individual ceases to be a qualified beneficiary if COBRA Continuation Coverage is not timely elected, or when the plan’s obligation to provide COBRA Continuation Coverage otherwise ends.

36-Month Qualifying Event

An affected qualified beneficiary (spouse or dependent child) of a covered retiree who would otherwise lose plan coverage may elect COBRA Continuation Coverage for a period not to exceed a maximum of 36 months from the date plan coverage would normally terminate if any of the following qualifying events occur:

• The legal separation or, if there is no legal separation, the dissolution of marriage of the spouse and retiree.
• The dependent child no longer qualifies as a dependent under the terms of the plan.

Notification Requirements

Under the law, the retiree or affected qualified beneficiary (spouse or dependent child) has the responsibility to notify the Trust Office of (1) a legal separation or, if there is no legal separation, the dissolution of marriage, and (2) a child losing dependent status under the plan. The retiree or affected qualified beneficiary (spouse or dependent child) must give this notice in writing to the Trust Office within 60 days of the later of (1) the date the qualifying event occurred, or (2) the date coverage would be terminated as a result of the qualifying event. If the Trust Office is not notified during the 60-day period, the qualified beneficiary (spouse or dependent child) will not be entitled to COBRA Continuation Coverage.

Family members who are newly acquired during a period of COBRA Continuation Coverage may be enrolled under the plan’s enrollment provisions, following timely notice to the plan (please see New Spouse Or Dependent Children).

When the Trust Office is notified of the qualifying event, an application is mailed to the qualified beneficiary (spouse or dependent child). The application must be completed and returned to the Trust Office within 60 days of the later of (1) termination of coverage under the Retired Plan, or (2) the date the application was sent to the qualified beneficiary (spouse or dependent child). If the application is not sent to the Trust Office by this date, the qualified beneficiary (spouse or dependent child) whose coverage under this plan is terminating will not be entitled to continue coverage under COBRA.

Cost And Payment

A qualified beneficiary (spouse or dependent child) must pay for COBRA Continuation Coverage. The cost of COBRA Continuation Coverage is based on the Trust’s costs to provide coverage to retirees, spouses and dependent children under the Carpenters Health and Security Plan – For Retired Carpenters. The current COBRA rates are listed on the application sent by the Trust Office. The initial payment must be made within 45 days from the date COBRA Continuation Coverage is elected (the application date). The initial payment covers the number of months from the date coverage would otherwise have terminated, including the month in which the initial payment is made. Thereafter, payments must be made monthly to continue coverage. Bills are mailed in the first week of the month for the following month’s coverage. Payment is due, in full, upon receipt of the bill but not later than 30 days from the beginning of the month to be covered. If the qualified beneficiary (spouse or dependent child) fails to make the initial payment, or any subsequent monthly payment, in a timely fashion, the qualified beneficiary’s (spouse or dependent child) coverage will terminate.

Termination Of COBRA Continuation Coverage

COBRA Continuation Coverage will end on the first of the dates below:

1. The last day of the month the maximum coverage period for the qualifying event has ended (36 months).
2. The last date for which payments were paid, when the qualified beneficiary (spouse or dependent child) does not make the next payment in full when due or by the end of the grace period set by COBRA.
3. The date the qualified beneficiary (spouse or dependent child) first becomes entitled to (covered by) Medicare, after the date of the COBRA election.
4. If a qualified beneficiary (spouse or dependent child) has added family members to his or her COBRA Continuation Coverage, coverage for those family members ends on the date that the qualified beneficiary’s coverage ends.
5. The date the Carpenters Health and Security Plan – For Employed Carpenters or the Carpenters Health and Security Plan – For Retired Carpenters is terminated by the Board of Trustees.

COBRA Continuation Coverage is provided subject to eligibility. The plan reserves the right to terminate COBRA Continuation Coverage retroactively if the qualified beneficiary is determined to be ineligible for coverage.