Health Insurance - Continuation Coverage/COBRA Law
Administrators | Human Resources

*VERY IMPORTANT NOTICE*

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 health 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 summary fashion, of your rights and obligations under the continuation coverage provisions of the law. (Both you and your spouse should take the time to read this notice carefully.)

If you are an employee of Roosevelt University covered by any University group health plan, herein after referred to as the Health Plan, you 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 Health Plan, you have the right to choose continuation coverage for yourself if you lose group health coverage under the 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 with Roosevelt University;

(3) Divorce or legal separation from your spouse; or

(4) Your spouse becomes eligible for Medicare.

In the case of a dependent child of an employee covered by the Health Plan, he or she has the right to continuation coverage if group health coverage under the Health Plan is lost for any of the following five reasons:

(1) Death of a parent;

(2) The termination of a parent’s employment (for reasons other than gross misconduct) or reduction in a parent’s hours of employment with Roosevelt University;

(3) Parent’s divorce or legal separation;

(4) A parent becomes eligible for Medicare; or

(5) The dependent ceases to be a dependent child under the Health Plan.

Under the law, the employee or a family member has the responsibility to inform the Associate Director, Human Resources Office (HR) of Roosevelt University of a divorce, legal separation, or a child losing dependent status under the Health Plan. The Associate Director, HR of Roosevelt University will also note any employee’s death, termination of employment or reduction in hours, or Medicare eligibility.

When the Associate Director, HR of Roosevelt University is notified that one of these events has happened, the Associate Director, HR of Roosevelt University 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 you would lose coverage because on one of the events described above to inform the Associate Director, HR of Roosevelt University that you want continuation coverage.

If you do not choose continuation coverage, your group health insurance coverage will end.

If you choose continuation coverage, Roosevelt University is required to offer you coverage which, as of the time coverage would otherwise end, is identical to the coverage provided under the plan to similarly situated employees or family members. As a COBRA enrollee, you will be eligible for the health plans that are available to Roosevelt University active employees on January 1 of each year, and will have the same rights as active employees to change health plan coverages during the regular open enrollment periods. The law requires that you be afforded the opportunity to maintain continuation coverage for up to 3 years (36 months) unless you lost group health coverage because of a termination of employment or reduction in hours. In that case, the required continuation coverage period is 18 months. However, the law also provides that your continuation coverage may be cut short for any of the following five reasons:

(1) Roosevelt University no longer provides group health coverage to any of its employees;

(2) The premium for your continuation coverage is not paid on a timely basis;

(3) You become an employee covered under another group health plan; however, continuation coverage cannot be termination after you obtain other group health coverage while the new coverage is limited with respect to, or excludes, pre-existing conditions unless your continuation coverage period ends;

(4) You become eligible for Medicare;

(5) You were divorced from a covered employee and subsequently remarry and are covered under your new spouse’s group health plan.

If you or your eligible dependent who is disabled at the time your employment is terminated or work hours are reduced at Roosevelt University gives notice of such disability before the end of the 18-month continuation period, continuation coverage for that disabled person can extend for up to 29 months provided you or your eligible dependent remains totally disabled.

You do not have to show that you are insurable to choose continuation coverage. However, as provided by the law, Roosevelt University will require you to pay 102% of the premium it is charged for your coverage (i.e., 2% more than the premium Roosevelt pays). The law also provides that, at the end of your continuation coverage period, you must be allowed to enroll in an individual conversion health plan provided under the Health Plan.

This law applied to the Health Plan beginning on January 1, 1987. If you have any questions about the law, please contact the Associate Director, Human Resources, Roosevelt University, 430 S. Michigan Avenue, Chicago, Illinois 60605. If you have changed your marital status, or your or your spouse change addresses, please notify the Associate Director, Human Resources of Roosevelt University at the above address.

HR 7/03 5/99

Human Resources | Benefits | Administrators