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COBRA

COBRA refers to the federal law entitled the Consolidated Omnibus Budget Reconciliation Act of 1985. Under this law, the Fund is required to offer a temporary extension of health coverage at group rates in certain instances when benefits would normally terminate.

Participant Eligibility
If you are employed by a contributing employer and covered by the Welfare Plan, you may elect COBRA continuation coverage if you lose your coverage due to a reduction in your hours or termination of your employment (for reasons other than gross misconduct).

Dependent Eligibility
Your spouse and dependent children have the right to continuation coverage if they lose coverage for any of the following reasons:

  1. the death of the participant,
  2. the termination of the participant’s employment (for reasons other than gross misconduct) or reduction in the participant’s hours of employment,
  3. divorce or legal separation,
  4. the participant becomes enrolled in Medicare (Part A, B or both), or
  5. a child ceases to be a “dependent” (see Eligibility and Enrollment for information on when a child is considered to be a dependent).

Duration of COBRA Coverage
The length of time that you may elect COBRA coverage is generally 18 months. Following are circumstances when COBRA coverage may extend beyond 18 months:

  1. If your family experiences another qualifying event while receiving the 18 months of continuation coverage, your spouse and dependent children may qualify for up to an 18-month extension (maximum of 36 months). This extension may be available to your dependents if you die, become enrolled in Medicare, have a divorce or legal separation, or if your child ceases to be a “dependent child.”
  2. If you or one of your qualified dependents become disabled before the 60th day of COBRA coverage, and the disability lasts through the end of the 18-month period, you may be entitled to an 11-month extension (maximum of 29 months). To be eligible for this extension, you or your family member must provide the Fund Office with a copy of your Social Security Disability Award letter within 60 days of the Social Security determination.

Please note that your COBRA coverage may be cut short if you do not pay your self-pay premium on time, become covered under another health plan (including Medicare), or are on an 11-month extension and are determined to be no longer disabled.

Cost of COBRA Coverage
The monthly cost of COBRA coverage during the 2017-2018 Plan year is:

 
Tier I
Tier II
Tier III
Participant
$526.97
$536.22
$1,029.47
Participant + 1
$1,015.53
$1,034.49
$2,045.66
Family
$1,488.78
$1,517.00
$3,021.41

Please note that if you have an 11-month disability extension, your premium will be approximately 150% of the premium rates listed above.

New York State Residents: You may be eligible for a 50% subsidy that is available to entertainment industry workers whose income is below a certain threshold (see COBRA Subsidy Application). Once the Fund Office is notified by the State Insurance Department that your application has been approved, we will notify you and change your required premium payment. Until that time, you are responsible for 100% of the premium.

Electing COBRA Coverage
When the Fund Office is notified or determines that a qualifying event has taken place, we will mail you forms that further explain your rights under COBRA and give you the opportunity to elect COBRA coverage. You have 60 days from the later of: (1) the date the coverage would normally terminate or (2) the date of the Fund Office’s notice to you of your COBRA rights, to make an election for COBRA coverage. If you do not make an election within the 60-day window, you will not be able to elect COBRA coverage.

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