Employee Manual 2025 - Flipbook - Page 58
(“Continuation Coverage”). The following (including the “Special Rules for COBRA Continuation
Coverage”) is a complete description of the circumstances that give rise to Continuation Coverage.
Continuation Coverage is available if you are enrolled in the Plan and you or your
covered dependent’s enrollment would end because:
1. You voluntarily end your employment with the City;
2. Your employment is voluntarily terminated by the City for a reason other than your gross
misconduct;
3. Your hours of work are reduced so that you are no longer eligible for group health plan
coverage;
4. You become divorced or legally separated;
5. You die;
6. Your child is no longer eligible to be a dependent;
7. You become entitled to Medicare; or
8. The bankruptcy of the City.
The above reasons are referred to as “Qualifying Events”.
Notification Responsibilities: If coverage will end because of divorce or legal separation, or
because a child is no longer eligible to be a dependent, you or your covered dependent must notify
the City’s human resources director immediately. If the Plan Sponsor (the City) is not notified
within sixty (60) days after coverage would otherwise end, coverage cannot be continued.
When the City receives your notice (or when your employment ends, your hours of work are
reduced so you are no longer a full-time employee, or you die), you and your covered dependents
will be notified by the City within 14 days about the right to continue coverage. If you or a covered
dependent(s) want to continue group health plan coverage, the election of coverage must be made
within sixty (60) days of the date the COBRA notice was sent to you.
Individuals Covered: You and each of your covered dependents can individually decide whether or
not to continue coverage, but the election of coverage by you or your spouse will be considered an
election of coverage by all covered individuals unless the election specifically names the individuals
to be covered or one or more covered individuals reject group health plan coverage.
Costs and Payments: Continuation Coverage is at your expense and will include a permissible
administrative fee. The monthly cost of this continued coverage is the cost to the City plus a 2%
administrative fee. If you or the covered dependent is disabled and continuing their coverage
under COBRA for 29 months, the employer is allowed to charge the disabled individual and the
non-disabled family members up to 150% of the applicable premium from the 19th to the 29th
month.
The monthly cost will be included in the notice sent to you. For coverage to continue, the first
premium must be received by the date stated in the notice sent to you. Normally, this date will be
forty-five (45) days after Continuation Coverage is elected. Premiums for every following month
City of Plymouth Employee manual - Page 58 – May 2025
