To all employees and family members covered under our group health insurance plan(s):

   

Under the Consolidated Omnibus Budget Reconciliation ACT (COBRA), you, as the COVERED employee and COVERED family members, may be entitled to uninterrupted continuation of group health insurance benefits at your own expense.

In order to keep you informed of your continuation coverage rights under COBRA, YOU must notify Human Resources of the following events when they occur:

Your rights under COBRA may cease if you do not inform us of:

• DIVORCE
• LEGAL SEPARATION
• DEPENDENT CHILD CEASING TO BE A DEPENDENT CHILD

          Notification of the above events must be made to us within 60 days from the later of the date of the event or

          the date the coverage is lost on account of the event.

• DISABILITY

          To qualify for the disability extension (an extension of continuation coverage from 18 to 29 months), a qualified

          beneficiary must be deemed to have been disabled before the end of the first 60 days of continuation coverage. 

          THE DETERMINATION OF DISABILITY FROM THE SOCIAL SECURITY ADMINISTRATION must be provided to us

          within 60 days of the determination and before the expiration of the 18-month COBRA continuation coverage

          period.