Notice of Right to Continue Group Health Coverage (COBRA)
CONSOLIDATED OMNIBUS BUDGET RECONCILIATION ACT
The right to COBRA continuation coverage was created by a
federal law, the Consolidated Omnibus Budget Reconciliation Act
of 1985 (COBRA). COBRA continuation coverage can become
available to you 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.
WHAT IS COBRA CONTINUATION COVERAGE?
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.
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 the full cost for COBRA
continuation coverage.
If you are an employee of Ithaca College, you will become a qualified beneficiary if you lose your coverage under the
Plan because either one of the following qualifying events happens:
Your hours of employment are reduced (loss of benefit eligibility), or
Your employment ends for any reason other than your gross misconduct.
If you are the spouse of an employee of Ithaca College, you will become a qualified beneficiary if you 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 (loss of benefit eligibility);
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 because any of the
following qualifying events happens:
The parent-employee dies;
The parent-employee's hours of employment are reduced (loss of benefit eligibility);
The parent-employee's employment ends for any reason other than his or her gross misconduct;
The parent-employee becomes entitled to Medicare benefits (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."
WHEN IS COBRA COVERAGE AVAILABLE?
The Plan will offer COBRA continuation coverage to qualified beneficiaries only after the Plan Administrator has been
notified that a qualifying event has occurred. When the qualifying event is the end of employment or reduction of hours
of employment, death of the employee, [ ass if Plan provides retiree health coverage: commencement of a proceeding in
bankruptcy with respect to the employer,] or the employee’s becoming entitled to Medicare benefits (under Part A, Part b
or both), the employer must notify the Plan administrator of the qualifying event.
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YOU MUST GIVE NOTICE OF SOME QUALIFYING EVENTS
For the other qualifying events (divorce or legal separation of the employee and spouse or a dependent child’s losing
eligibility for coverage as a dependent child), you must notify the Plan Administrator within 60 days after the qualifying
event occurs.
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HOW IS COBRA PROVIDED?
Once the Plan Administrator receives notice that a qualifying event has occurred, COBRA continuation coverage will be
offered to each of the qualified beneficiaries. Each qualified beneficiary will have an independent right to elect COBRA
continuation coverage. Covered employees may elect COBRA continuation coverage on behalf of their spouses, and
parents may elect COBRA continuation coverage on behalf of their children.
COBRA continuation coverage is a temporary continuation of coverage. When the qualifying event is the death of the
employee, the employee’s becoming entitle to Medicare benefits ( under Part A, Part B or both), your divorce or legal
separation or a dependent child’s 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 became entitled to Medicare benefits less than 18 months before the qualifying event,
COBRA continuation coverage for qualified beneficiaries other then the employee lasts until 36 months after the date of
Medicare entitlement. For example, if a covered employee becomes entitled to Medicare 8 months before the date on
which his employment terminates, COBRA continuation coverage for his spouse and children can last up to 36 months
after the date of Medicare entitlement, which is equal to 28 months after the date of the qualifying event (36 months
minus 8 months). Otherwise, when the qualifying event is the end of employment or reduction of the employee’s hours,
COBRA continuation coverage generally lasts for only up to a total of 18 months. There are two ways in which this
18-month period of COBRA continuation coverage can be extended.
Disability extension of 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 and you notify the
Plan administrator in a timely fashion, you and your entire family may be entitled to receive up to an additional
11 months of COBRA continuation coverage, for a total of 29 months. The disability would have to have
started at some time before the 60th day of COBRA continuation coverage and must last at least until the end
of the 18-month period of continuation coverage.
Second Qualifying event extension of 18-month period of continuation coverage: If your family
experiences another qualifying event while receiving 10 months of COBRA continuation coverage, the spouse
and dependent children in your family can get up to 10 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 the former employee dies, becomes entitled 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
has the first qualifying event not occurred.
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IF YOU HAVE QUESTIONS
Questions concerning your plan or your COBRA continuation or your COBRA continuation rights should be addresses to
the contact identified below. For more information about your rights under ERISA, including COBRA, the Health
Insurance Portability and Accountability Act (HIPPA), and other laws affecting group health plans, contact the nearest
Regional or Distract Office of the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) In your
area or visit the EBSA website at www.dol.gov/ebsa.
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KEEP YOUR PLAN ADMINISTRATOR 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 the family members. You should also keep a copy, for your records, of any notices you send to the Plan
Administrator.