Employee Manual 2023 - Flipbook - Page 56
not to continue coverage, but the election of coverage by you or your spouse will be considered an
election of coverage by all covered individuals unless the election specifically names the individuals
to be covered or one or more covered individuals reject group health plan coverage.
Costs and Payments: Continuation Coverage is at your expense and will include a permissible
administrative fee. The monthly cost of this continued coverage is the cost to the City plus a 2%
administrative fee. If you or the covered dependent is disabled and continuing their coverage
under COBRA for 29 months, the employer is allowed to charge the disabled individual and the
non-disabled family members up to 150% of the applicable premium from the 19th to the 29th
month.
The monthly cost will be included in the notice sent to you. For coverage to continue, the first
premium must be received by the date stated in the notice sent to you. Normally, this date will be
forty-five (45) days after Continuation Coverage is elected. Premiums for every following month of
Continuation Coverage must be paid monthly on or before the premium due date stated in the
notice sent to you (this date will be no greater than 30 days). The first day for which timely
payment is not made will result in termination of COBRA Continuation Coverage.
Newborns and Adopted Children: If you or your spouse elects Continuation Coverage, any child
born to or adopted by you and your spouse during the period of Continuation Coverage will also be
entitled to Continuation Coverage for the remaining period of your entitlement. Such newborns or
adopted children must be properly enrolled within thirty (30) days of birth or adoption, and the
child’s period for COBRA Continuation Coverage will end at the same time as would the maximum
period of coverage for other family members.
Spouse and Dependents of Medicare-Eligible Employees: If Continuation Coverage was elected by
the spouse or dependent child of a covered employee who became entitled to Medicare prior to a
loss of coverage under the plan, the maximum period of Continuation Coverage for the spouse or
child is the longer of:
1. thirty-six (36) months from the date the covered employee became entitled to Medicare, or
2. eighteen (18) months from the date of the qualifying termination of employment.
Coverage will still end for any of the other reasons listed above, such as failure to pay premiums
when due, etc.
Disabled Individuals: If a covered individual is disabled at the time they first become eligible for
COBRA Continuation Coverage or is disabled within the first sixty (60) days of the Continuation
Coverage period, the maximum period of Continuation Coverage is extended to twenty-nine (29)
months. In addition, all covered individuals who became qualified beneficiaries on account of the
same qualifying event as did the disabled covered individual are also eligible for the additional
eleven (11) months of COBRA Continuation Coverage. (Coverage will still end for any of the other
reasons listed above, such as failure to pay premiums within the 30-day grace period.)
The covered individual must notify the City within sixty (60) days of the date they are determined
City of Plymouth Employee manual - Page 56 – March 2023
