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On April 7, 1986, a federal law was enacted (Public Law 99-272, commonly called “COBRA”). This law requires the state of Texas to offer employees and dependents covered under the Uniform Group Insurance Program (UGIP) the opportunity to temporarily extend their health and dental coverage at the group rate. Continuation coverage is available only when qualifying events cause coverage under the UGIP to end. Coverage under COBRA is limited to the health and dental coverage in effect at the time of the qualifying event.
Who May Continue Coverage If you are an employee covered under the UGIP, you and/or your covered dependents have the right to choose up to 18 months of continuation coverage if your UGIP coverage ended due to:
If you are a dependent covered by an employee under the UGIP, you have the right to choose up to 36 months of continuation coverage if your UGIP coverage terminates due to loss of dependent status, including such qualifying events as:
If you are a former employee’s dependent continuing UGIP coverage under COBRA as a result of the former employee’s termination of employment, expiration of coverage following leave without pay or loss of UGIP eligibility due to reduction in hours, you have the right to extend your coverage for a total continuation of up to 36 months if you lose eligible-dependent status under the rules of the UGIP provided you were covered as a dependent at the time of the initial qualifying event. Beginning Jan. 1, 1997, a COBRA participant’s newborn child or newly adopted child acquired on or after the initial qualifying event also will have a right to extend their coverage. Qualifying events that occur during the initial 18 months of continuation of coverage that entitle covered dependents to the additional continuation period are:
Election Period For employees and dependents eligible for continuation coverage
The ERS will provide you with a COBRA Election Form and COBRA Notification (pdf) following the termination of your coverage. You and/or your dependents must formally elect continuation coverage on the form provided and submit the appropriate premium payment within 105 days of the date coverage terminated or the date of notice, whichever is later. Failure to do so will result in the forfeiture of your continuation coverage. Each covered participant has the right to elect continuation coverage independently. You and your dependents will not have coverage after the date coverage terminated until you formally elect continuation coverage and pay all premiums due retroactive to the first day of the month following the date coverage terminated.For dependents whose coverage terminates due to loss of dependent status
The member or the covered dependent has the responsibility to notify one of the following of a divorce or when a covered dependent loses dependent status. Notification must occur within 60 days of the qualifying event date.
Upon notification the ERS will provide a form for the dependent to complete and forward to the ERS with the appropriate premium within 105 days of the date of notice on the form or the date coverage terminated, whichever is later. If the benefits coordinator or ERS is not notified within 60 days, continuation coverage will be forfeited.
Adding newly acquired dependents during the election period
Newly acquired dependents may be added to the COBRA continuation coverage provided the ERS is notified in writing within 30 days of the date the individual first became an eligible dependent. This rule also applies during the 105-day election period. Example: An employee terminated employment on July 20 and acquired an eligible dependent on Aug. 5. To add the new dependent to the COBRA continuation coverage, the request must be postmarked on or before Sept. 4 even though the 30-day notification deadline occurs before the end of the 105-day election period.
Cost of Continuation Coverage
People electing continuation coverage must pay the full premium plus an additional 2 percent administrative fee. The first premium payment is due within 105 days from the date of the COBRA qualifying event or the date of notice, whichever is later. If you will receive an annuity from ERS, your monthly premium will be automatically deducted from your monthly annuity payment. To ensure that no break in coverage occurs, the first premium payment must include all premiums due retroactively to the first day of the month following the date coverage terminated. Subsequent monthly payments are due on the first of each coverage month and must be postmarked by the U.S. Postal Service within 30 days of the due date. If your payment is late, your coverage will be automatically canceled retroactive to the last day of the month in which a full payment was received and was not considered delinquent.
Length of Continuation Coverage
Your continuation coverage may be canceled for any of the following reasons:
PLEASE NOTE: Canceled continuation coverage cannot be reinstated.