Qualifying Events

Qualifying Events

A qualifying event is an event described below that causes either you or a Dependent to lose Plan coverage.

If you are an Employee, you will have a qualifying event and will have the right to choose continuation coverage if you lose your group health coverage because of a reduction in your hours of employment or the termination of your employment (for reasons other than gross misconduct).  If you are on FMLA leave, you will experience a qualifying event if you do not maintain employment at the end of your FMLA leave and would, in the absence of COBRA continuation coverage, lose coverage under a group health plan.  Your maximum coverage period will then be measured from the last day of your FMLA leave unless coverage is actually lost at a later date.  You also will experience a qualifying event at the end of an FMLA leave if your employment then ends, even if your coverage lapsed when you were on FMLA leave.

If you are the Spouse or Domestic Partner of an Employee, you have the right to buy COBRA coverage for yourself if you lose Plan coverage for any of the following reasons:

• The Employee’s death;
• The termination of the Employee’s employment (for reasons other than gross misconduct) or reduction in the Employee’s hours of employment;
• Divorce or legal separation from the Employee, or dissolution or other legal termination of the marriage or Domestic Partnership. (If the Employee cancels your coverage in anticipation of your divorce, dissolution or separation, that cancellation will be disregarded in determining whether you are COBRA-eligible).

A Dependent child can buy COBRA coverage (or it may be purchased for the child) if the child loses Plan coverage for any of the following reasons:

• The death of the Employee;
• The termination of the Employee’s employment (for reasons other than gross misconduct) or reduction in the Employee’s hours of employment;
• Parents’ divorce or legal separation or dissolution or other legal termination of the marriage or Domestic Partnership;
• The dependent child ceases to be a “Dependent” as defined under the Plan.

You may buy COBRA continuation coverage for an eligible child who is born to, adopted by, or placed for adoption with you while your COBRA continuation coverage (or right to elect COBRA continuation coverage) is effective, provided that you notify the Administrator in writing within 30 days of the child’s birth, adoption or placement for adoption.

The Administrator reserves the right to terminate continuation coverage retroactively if you or your Dependent are determined to be ineligible for coverage.