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Continued Coverage

Under a federal law called the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), as amended, group health plans are required to offer temporary continuation of health coverage in certain situations when coverage would otherwise end. You may continue coverage for yourself and for each person who qualifies as an eligible dependent under the Plan provided that you elect continued coverage in a timely manner and pay the cost required.

However, only a person covered under the Plan before the initial Qualifying Event which caused your loss of coverage or a child born to or adopted by the Member or spouse following the initial Qualifying Event will be considered a Qualified Beneficiary. In general, a Qualified Beneficiary is the Member, the Member’s spouse or the Member’s dependent children who were covered under the Plan on the day before the initial Qualifying Event; collateral dependents are not Qualified Beneficiaries. Qualified Beneficiaries have a separate right to elect coverage if you do not elect to cover them or if they subsequently lose coverage under the Plan due to a subsequent Qualified Event.

This chart shows which Qualified Beneficiaries may elect continued coverage under COBRA when loss of coverage due to a Qualifying Event occurs, and how long the Qualified Beneficiary may continue coverage. In general, on the date a person enrolls for and becomes entitled to benefits under Medicare, his/her coverage under COBRA continuation ends. However, if the individual were covered under Medicare before continued coverage was elected, he/she may elect to be covered under COBRA continuation coverage. Please keep in mind that the following information is a summary of the law and, therefore, is general in nature. When MILA receives notice that your coverage has terminated due to a Qualifying Event, it will provide you with a complete notice of your rights and obligations if you elect continued coverage.

If you marry, have a newborn child or have a child placed with you for adoption while you’re covered under COBRA, you may enroll that spouse or dependent child for coverage for the balance of the COBRA continuation period under the same conditions that apply to active Members. Only the children born to or adopted by the Member will be Qualified Beneficiaries. Your new spouse and new dependent children (your new spouse’s children) will not be Qualified Beneficiaries. The same rules which govern dependent eligibility and qualifying changes in family status that apply to active Members will apply to persons covered under COBRA Continuation Coverage.