Employee Manual 2025 - Flipbook - Page 59
of Continuation Coverage must be paid monthly on or before the premium due date stated in the
notice sent to you (this date will be no greater than 30 days). The first day for which timely
payment is not made will result in termination of COBRA Continuation Coverage.
Newborns and Adopted Children: If you or your spouse elects Continuation Coverage, any child
born to or adopted by you and your spouse during the period of Continuation Coverage will also be
entitled to Continuation Coverage for the remaining period of your entitlement. Such newborns or
adopted children must be properly enrolled within thirty (30) days of birth or adoption, and the
child’s period for COBRA Continuation Coverage will end at the same time as would the maximum
period of coverage for other family members.
Spouse and Dependents of Medicare-Eligible Employees: If Continuation Coverage was elected by
the spouse or dependent child of a covered employee who became entitled to Medicare prior to a
loss of coverage under the plan, the maximum period of Continuation Coverage for the spouse or
child is the longer of:
1. thirty-six (36) months from the date the covered employee became entitled to Medicare, or
2. eighteen (18) months from the date of the qualifying termination of employment.
Coverage will still end for any of the other reasons listed above, such as failure to pay premiums
when due, etc.
Disabled Individuals: If a covered individual is disabled at the time they first become eligible for
COBRA Continuation Coverage or is disabled within the first sixty (60) days of the Continuation
Coverage period, the maximum period of Continuation Coverage is extended to twenty-nine (29)
months. In addition, all covered individuals who became qualified beneficiaries on account of the
same qualifying event as did the disabled covered individual are also eligible for the additional
eleven (11) months of COBRA Continuation Coverage. (Coverage will still end for any of the other
reasons listed above, such as failure to pay premiums within the 30-day grace period.)
The covered individual must notify the City within sixty (60) days of the date they are determined
to be disabled under the Social Security Act and prior to the end of the initial eighteen (18) months
of coverage. In addition, the covered individual must also provide notice within thirty (30) days of
the date they are finally determined not to be disabled. (Coverage will end on the first day of the
month beginning after (30) days after the covered individual is determined not to be disabled.) The
cost of Continuation Coverage will increase after the 18th month of Continuation Coverage (to 150
percent) for all qualified beneficiaries who remain covered unless the disabled individual does not
elect to continue the group health plan coverage.
Secondary Events: The term COBRA Standard Secondary Events simply means one Qualifying
Event stacking on top of another. It allows a Qualified Beneficiary who is already on COBRA to
extend COBRA coverage, under certain circumstances, from 18 months to 36 months of coverage.
In Standard Secondary Events, the 36 months of coverage extends from the date of the original
Qualifying Event.
City of Plymouth Employee manual - Page 59 – May 2025
