Compliance and COBRA

The Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 is a Federal law that requires most employers sponsoring Health Care plans to offer employees and their dependents the opportunity for a temporary extension of health coverage under the employer's plan in instances where coverage under the plan might otherwise end.

If you are a BGSU employee covered by the University's Health Care Program, you have a right to choose continued coverage if you lose your health coverage because of a change in your classification or termination of employment (for reasons other than gross misconduct).

If you are the spouse of an employee covered by the Health Care Program, you have a right to choose continued coverage for yourself if you lose health coverage under the Program due to the following qualifying events:

  • The death of your spouse;
  • A termination of your spouse's employment (for reasons other than gross misconduct) or reduction in your spouse's hours of employment;
  • Divorce or legal separation from your spouse; or
  • Your spouse becomes entitled to Medicare.

In the case of a dependent child of an employee covered by the Health Care Program, he/she has the right to continuation of coverage if coverage under the Program is lost for any of the following reasons:

  • The death of an employee-parent;
  • The termination of parent's employment (for reasons other than gross misconduct) or reduction in a parent's hours of employment;
  • Parent's divorce or legal separation;
  • A parent becomes entitled to Medicare; or
  • The dependent ceases to qualify for coverage as a "dependent child."

Under the law, you or a family member have the responsibility to inform BGSU of a divorce, legal separation or a child losing dependent status under the plan within 60 days of the event happening. If notice is not received within that 60-day period, your dependent will not be entitled to choose continuation of coverage.

When BGSU is notified of one of these events, you will be notified in writing that you have the right to choose continuation coverage, from Chard Snyder. You have 60 days to choose or reject continuation coverage and then an additional 45 days to pay your first premium. It is your responsibility to notify the Benefits Office and provide a current address.

You have 60 days from the later of:

  • The date you would lose coverage; or
  • The date you receive notice from BGSU of your continuation coverage rights because of one of the events described above.

If you do not choose to continue coverage, your health coverage ends.

If you choose continuation of coverage, BGSU is required to give you coverage which, as of the coverage is provided, is identical to the coverage provided under the Plan to similarly situated employees or family members. You may elect to maintain continuation coverage for three years unless you lose your medical coverage because of termination of employment or reduction in hours. In that case, the required continuation coverage period is 18 months. If during that 18-month period, another event takes place that would also entitle your spouse or dependent child to continuation coverage, the coverage may be extended to a total of 36 months from the original qualifying event. This provision applies to a dependent other than a spouse or child who became covered after continuation coverage became effective. Your spouse or dependent child can elect to continue the coverage for 36 months from the date of the qualifying event due to your becoming entitled to Medicare.

If you or your covered dependent are disabled, as defined under Social Security law, at the time of your termination of employment or reduction in hours, and you provide notice of this finding to the Benefits Office within 18 months of your termination of employment or reduction in hours, you may extend the continuation coverage to a total of 29 months. The additional 11 months of continuation coverage will, however, be at a higher contribution. In no case will any period of continuation coverage be more than 36 months. The law, however, also provides that your continuation coverage may be terminated before the end of the continuation period (i.e., 18, 29, or 36 months) for any of the following reasons:

  • BGSU no longer provides health coverage to any of its employees;
  • The contribution for your continuation coverage is not paid in a timely fashion;
  • You become covered under another plan, unless the new plan excludes coverage for a pre-existing condition which you, your spouse or dependent child has;
  • You become entitled to Medicare; or
  • Your disability ends if the disability occurred while covered under COBRA.

You do not have to show that you are in good health to choose continuation coverage. You will, however, have to pay the full contribution amount for your continuation coverage. The contribution for the additional 11 months of coverage, if you are found disabled under the Social Security law, will be 150% of the regular continuation contribution. You have a grace period of at least 45 days to pay any retroactive contribution for the period from the date continuation coverage starts to the date you chose continuation coverage; and you have a grace period of at least 30 days to pay any subsequent premiums.