UFCW LOCAL 1776 and PARTICIPATING EMPLOYERS
HEALTH and WELFARE FUND

Continuing Coverage Under COBRA

Under the Consolidated Omnibus Budget Reconciliation Act (COBRA), you have the right to continue your group medical coverage for a period of time even after you are no longer employed.
Your spouse (and dependent children) may also continue coverage if they would lose coverage for one of the reasons listed. Each individual covered under the Plan (you, your spouse, and your dependents) has the right to make his or her own decision about COBRA continuation coverage. Both you and your spouse should read this section.

Qualifying Events

Your right to continue coverage applies if you lose coverage because of one of the following events:

Events that apply to employees

Your employment is terminated for any reason except gross misconduct.

Your work hours are reduced.

Events that apply to spouse

Your spouse's employment is terminated, or your spouse's work hours are reduced.

Your spouse dies.

Your spouse becomes covered by Medicare.

You and your spouse become divorced.

Events that apply to dependents

Your parent's employment is terminated, or your parent's work hours are reduced.

Your parent dies.

You no longer qualify as a "dependent" under the terms of the Plan. Please refer to the section titled "Who is Eligible".)

Type of coverage
Generally, you can elect to receive the same type of group health care coverage you had immediately prior to the qualifying event. However, your benefits will change if the Fund's benefit plan change.

Maximum coverage period
You and your spouse and dependents may elect to continue coverage up to a maximum period as follows:

Up to 18 month from the date coverage is lost in the event of your termination of employment or reduction in your work hours, or

Up to 29 month if you, your spouse or your dependant is found by the Social Security Administration (SSA) to have been disabled at any time during 60 days of your continuation coverage, but only if the disabled person (or a member of his or her family) notifies the Fund Administrator of SSA's determination within 60 days after he or she receives the notice of the determination and before the end of the 18 month coverage period, or

Up to 36 month in all other cases.

If you, your spouse or your dependent has elected continuation coverage following a termination of employment or reduction in hours and a second qualifying event occurs during the initial 18 month period of continuation coverage, your total period of continuation coverage may last up to 36 months from the date coverage was lost on account of your termination of employment or reduction in hours.

Note: continuation coverage begins on the date you would otherwise lose your group health care coverage.

Newborn and Adopted Children
If, while you are receiving continuation coverage, you have a child born or placed with you for adoption, you may immediately enroll the child. Note that the cost of providing COBRA coverage to the child may increase the cost of the COBRA premium. In order to cover the child, you must notify the Fund office within thirty (30) days of the birth or placement for adoption.

Please note that the child will be treated as a "qualified beneficiary" with independent COBRA rights. Therefore, if another event occurs during the initial 18 month period of continuation coverage, the child will be able to elect to extend coverage for a period of up to 36 month from the date coverage was lost on account of the participant's termination of employment or reduction in hours. For example, if the covered employee dies or becomes covered by Medicare, or if the dependent ceases to meet the Fund's definition of "dependent", the child will be able to elect additional coverage extending thirty six (36) months from the date that the covered employee first began COBRA coverage.

Spouses
If, while you are receiving continuation coverage, you get married, your new spouse may be enrolled immediately. Your spouse, however, will not be treated as a "qualified beneficiary" with independent COBRA rights. Please contact the Fund office for details.

Cost of continuation coverage
You must pay the premiums for continuation coverage. The charge for the coverage is equal to the Fund's cost of providing group coverage plus two percent. This two percent charge covers a portion of the administrative cost to provide you the coverage. If you are disabled, the charge for you coverage for any month after the first 18 month of continuation coverage may be increased to up to 150% of the Fund's cost of providing group coverage. If there is an increase or decrease in the Fund's cost, your future premiums will be adjusted accordingly.