What is COBRA?
If coverage for you or your eligible family members under the medical or dental benefits offered by MIT ceases because of certain “special enrollment events” (for example, termination of employment, reduction in hours, divorce, death, or a child’s ceasing to meet the definition of an eligible dependent), then you and your eligible family members may have the right to purchase continuation coverage for a temporary period of time under the federal law known as the Consolidated Omnibus Budget Reconciliation Act of 1996 (“COBRA”).
Who is Eligible for COBRA under MIT?
The following serve as Qualified Beneficiaries for COBRA coverage:
- Any individual who, on the day before a Special Enrollment Event, is covered under the MIT Benefit by virtue of being on that day either a covered employee, the spouse of a covered employee (as recognized under federal law), or an eligible child of a covered employee.
- Any child who is born to or placed for adoption with a covered employee during a period of COBRA continuation coverage, and any individual who is covered by the MIT Benefit as an alternate recipient under a qualified medical support order.
When to Apply for COBRA coverage?
You must elect CORBA coverage during what is known as the election period. The election period begins not later than the date the Qualified Beneficiary would lose coverage on account of the Special Enrollment Event and ends 60 days after the later of the date the Qualified Beneficiary would lose coverage on account of the Special Enrollment Event or the date notice is provided to the Qualified Beneficiary of her or his right to elect COBRA continuation coverage. If coverage is not elected within the 60 day period, all rights to elect COBRA continuation coverage are forfeited.
Responsibility for Informing MIT of the Occurrence of a Special Enrollment Event. We will offer COBRA continuation coverage to Qualified Beneficiaries only after MIT has been timely notified that a Special Enrollment Event has occurred. Your Participating Employer will notify MIT of the Special Enrollment Event within 30 days following the date coverage ends when the Special Enrollment Event is:
- the end of employment with the Participating Employer or reduction of hours of employment;
- death of the employee; or
- enrollment of the employee in any part of Medicare.
Payment for COBRA Coverage
For any period of COBRA continuation coverage under the Plan, Qualified Beneficiaries who elect COBRA continuation coverage are required to pay 102% of the applicable premium and 150% of the applicable premium for any expanded period of COBRA continuation coverage covering a disabled Qualified Beneficiary due to a disability extension. MIT will inform you of the cost.
Payment for COBRA continuation coverage may be made in monthly or other installments, as approved by MIT. A “reasonable period of time” is 30 days after the notice is provided. A shortfall in a timely payment is not significant if it is no greater than the lesser of $50 or 10% of the required amount. Payment is considered made on the date on which it is postmarked to MIT.
When COBRA Coverage May Be Terminated
- The last day of the applicable maximum coverage period;
- The first day for which timely payment is not made to MIT with respect to the Qualified Beneficiary;
- The date upon which your Participating Employer ceases to provide any group health plan to any employee;
- The date, after the date of the election, that the Qualified Beneficiary first becomes covered under any other plan that does not contain any exclusion or limitation with respect to any pre-existing condition, other than such an exclusion or limitation that does not apply to, or is satisfied by, the Qualified Beneficiary;
- The date, after the date of the election, that the Qualified Beneficiary first enrolls in the Medicare program (either part A or part B, whichever occurs earlier);
- In the case of a Qualified Beneficiary entitled to a disability extension, the later of: (a) 29 months after the date of the Special Enrollment Event, or (b) the first day of the month that is more than 30 days after the date of a final determination under Title II or XVI of the Social Security Act that the disabled Qualified Beneficiary whose disability resulted in the Qualified Beneficiary’s entitlement to the disability extension is no longer disabled, whichever is earlier; or
- The end of the maximum coverage period that applies to the Qualified Beneficiary without regard to the disability extension.
For additional questions related to COBRA, please email MITinfo@scmedical.org.