Common use of Duration of Continuation Coverage Clause in Contracts

Duration of Continuation Coverage. (a) Continuation Coverage shall extend for a period of 18 months after the date that regular coverage ends due to the Employee's termination of employment or reduction of hours of employment to a level that disqualifies him or her from participation in the Plan, or for a period of 29 months if the Social Security Administration (SSA) determines within the 18- month period that any Qualified Beneficiary was disabled during the first 60 days of Continuation Coverage. However, if the Covered Employee was entitled to Medicare benefits at the time of the Qualifying Event of his or her termination of employment or reduction of hours, each Covered Dependent shall be eligible to continue coverage for up to 36 months from the date the Covered Employee first became so entitled. For purposes of determining continuation coverage rights “entitlement” means actual enrollment for Medicare benefits. (b) In order to secure the extended coverage after a determination of disability, the disabled Qualified Beneficiary must notify the plan administrator of SSA's finding within 60 days of its issue. If, during the 18-month period, a subsequent Qualifying Event occurs, the Covered Employee and each other Qualified Beneficiary having Continuation Coverage shall be entitled to elect to continue coverage under the Plan for up to 36 months following the date coverage was originally lost due to termination of employment or reduction of hours. (c) In addition, 36 months of Continuation Coverage shall be available to: (i) the Employee's spouse who loses coverage under this plan by ceasing to be a “Dependent” (as defined in Section 1.7) by virtue of a divorce or legal separation; (ii) a dependent child of the Employee who loses coverage by ceasing to be a dependent as defined by Code Sec. 152; (iii) any Covered Dependent who loses coverage where the Qualifying Event is the Employee's death; (iv) any Covered Dependent, where the Employee's entitlement to Medicare benefits results in loss of coverage under this Plan; or (v) any of the Employee's Covered Dependents if the Qualifying Event is the Employer's entering bankruptcy proceedings (or 36 months from the Employee's death, if later). In no event, however, shall Continuation Coverage extend more than 36 months beyond the date of the original Qualifying Event.

Appears in 1 contract

Sources: Health Reimbursement Arrangement

Duration of Continuation Coverage. Subject to Section 5.09, COBRA coverage timely and properly elected by any Qualified Beneficiary under this Article V shall extend for a period that begins on the date of the Qualifying Event, and ends on the earliest of the following dates: (a) In the case of a Qualified Event described in Section 5.03(b) or (f), Continuation Coverage shall extend for a period of 18 up to eighteen (18) months after the date that regular coverage ends ceased due to the Employee's termination occurrence of employment or reduction of hours of employment to a level that disqualifies him or her from participation in the PlanQualifying Event, or for provided however: (i) if a period of 29 months if the Social Security Administration (SSA) determines within the 18- month period that any Qualified Beneficiary was is determined to have been disabled during the first within 60 days of Continuation Coverage. However, if the Covered Employee was entitled to Medicare benefits at the time of the Qualifying Event under Title II and XVI of his or her termination the Social Security Act, then all covered family members of employment or reduction of hours, each Covered Dependent the disabled individual shall be eligible entitled to continue coverage for up an extension of the maximum period of Continuation Coverage if the Qualified Beneficiary has timely notified the Plan Administrator of such determination in accordance with Section 5.05(b). Continuation Coverage may be extended to 36 the date which is the earlier of (i) 29 months calculated from the date of the Covered Employee Qualifying Event, or (ii) the first became so entitled. For purposes day of determining continuation coverage rights “entitlement” means actual enrollment for Medicare benefits.the month commencing more than thirty (30) days after a final determination that the Qualified Beneficiary is no longer disabled; and (bii) In order to secure if another Qualifying Event (other than the extended coverage after a determination of disability, the disabled Qualified Beneficiary must notify the plan administrator of SSA's finding within 60 days of its issue. If, Qualifying Event in Section 5.03(b) or (f)) occurs during the such eighteen (18-) month period, a and the Qualified Beneficiary has timely notified the Plan Administrator of the occurrence of the subsequent Qualifying Event occursin accordance with Section 5.05(c), the Covered Employee and each other Qualified Beneficiary having Continuation Coverage shall be entitled extended to elect to continue coverage under the Plan for up to 36 months following the date coverage was originally lost due to termination of employment or reduction of hours. which is thirty-six (c36) In addition, 36 months of Continuation Coverage shall be available to: (i) the Employee's spouse who loses coverage under this plan by ceasing to be a “Dependent” (as defined in Section 1.7) by virtue of a divorce or legal separation; (ii) a dependent child of the Employee who loses coverage by ceasing to be a dependent as defined by Code Sec. 152; (iii) any Covered Dependent who loses coverage where the Qualifying Event is the Employee's death; (iv) any Covered Dependent, where the Employee's entitlement to Medicare benefits results in loss of coverage under this Plan; or (v) any of the Employee's Covered Dependents if the Qualifying Event is the Employer's entering bankruptcy proceedings (or 36 months from the Employee's death, if later). In no event, however, shall Continuation Coverage extend more than 36 months beyond after the date of the original Qualifying Event. (b) In the case of an event described in Section 5.03(d), the period of coverage for Qualified Beneficiaries other than the Participant shall be extended to the date which is thirty-six (36) months after the date the Participant became entitled to benefits under Title XVIII of the Social Security Act, regardless of whether such entitlement preceded the Qualifying Event, was the sole Qualifying Event or the second Qualifying Event. (c) In the case of any other Qualifying Event, Continuation Coverage shall be extended to the date which is thirty-six (36) months after the date of the Qualifying Event.

Appears in 1 contract

Sources: Health Care Reimbursement Arrangement