Individual Continuation of Services: Federal COBRA Provisions Sample Clauses

Individual Continuation of Services: Federal COBRA Provisions. A subscriber or eligible dependents may choose to continue coverage under the agreement if their coverage would othe1wise end due to a Qualifying Event, as listed below. 4.22.1 The Federal Consolidated Omnibus Reconciliation Act of 1985 provides for the continuation of health insurance coverage for eligible enrollees and their dependents, of Employers/Trusts with 20 and over eligible Enrollees, for a defined period of time after certain qualifying events occurs. Ordinarily, an enrollee's benefits will cease when Employer/Trust's group coverage terminates or under any other circumstance listed in "Termination of Benefits." However, in the case of certain qualifying events, a qualified enrollee and enrollee's Eligible Dependents may be able to continue group plan coverage under federal COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985) provisions for a limited time, if enrollee agrees to pay the Premium for such coverage. A qualified enrollee is an enrollee, who on the day before a qualifying event, is an enrollee in a group benefit plan offered by a health care service plan, and who has a qualifying event. A qualifying event is limited to the following: death of covered enrollee; termination of employment for reasons other than gross misconduct; divorce or legal separation of the covered enrollee from the covered enrollee's spouse; or loss of dependent status by a dependent enrolled in the Group Plan. 4.22.2 The qualified enrollee shall, upon election, be able to continue his or her coverage under the Employer Group Plan Contract, subject to the Group Plan's terms and conditions, for a limited amount of time. The enrollee must elect COBRA coverage by notifying the enrollee's Employer/Trust in writing within sixty (60) days of the date of the qualifying event. The written request must be delivered by first class mail, or other reliable means of delivery, including personal delivery, express mail, or private courier company, to the Employer/Trust within the sixty (60) day period following the later of 1) the date that the enrollee's coverage under the Group Plan Contract terminated or will terminate by reason of a qualifying event, or 2) the date the enrollee was sent notice of the ability to continue coverage under the Group Plan Contract. 4.22.3 The failure to notify the Employer/Trust within the required sixty (60) days will disqualify the qualified beneficiary from receiving continuation coverage under COBRA provisions. An enrollee electing co...