The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events.

If the following continuation rights are elected, the only continuation rights will be those set out in this section.

You and your Dependents who are covered under this Plan on the day before a Qualifying Event have the right to elect Continuation of Group Coverage if such coverage would otherwise terminate by reason of a Qualifying Event. This provision for continuation of Group Coverage will not apply if your Employer ceases to maintain any group health plan for any Employee.

The Qualifying Events are:

• Your death; or
• Termination of your employment (except for gross misconduct), or reduction of your hours of employment; or
• Your divorce or legal separation from your spouse; or
• Your becoming covered for benefits under Medicare. This is a second Qualifying Event for your Dependents when it causes them to lose continuation coverage which they had because of termination or reduction of your employment; or
• Your Dependent child ceasing to be a Dependent as defined in this Plan; or
• With respect to Covered Retirees and their Dependents, a substantial elimination of health coverage within one year before or after the commencement of Title XI bankruptcy proceedings by the Employer/Group.

Continuation must be elected within an Election Period of 60 days. The 60 day period starts on the later of:

• The date coverage would otherwise terminate because of a Qualifying Event; or
• The date the Employer furnishes notice of the right to elect continuation.

Election of continuation by any qualified Covered Person shall be deemed to include an election of continuation on behalf of any other qualified Covered Person whose coverage under this Plan would otherwise terminate by reason of the same Qualifying Event. However, if You reject any coverage. your Dependents may elect to retain any rejected coverage.

The full Contribution must be paid to the Employer or Plan. This includes any portion of the Contribution which was previously paid by the Employer. The first contribution should be for the period between the Qualifying Event and the date of election plus the 30 day period immediately following the election date. It is due on the date of election and must be paid no later than 45 days after the date of election. Continuation will "ot be allowed at a later date for any person for whom the first Contribution is not paid within this 45 day period. Contributions for subsequent periods must be paid within 30 days of the due date. If the contributions received are less than the total Contributions due, they will be applied to the period beginning when coverage would otherwise terminate. Coverage will then terminate at the end of the last month for which a full Contribution was received, and any unused partial Contribution will be refunded.

The following notices are required to be furnished:

• A qualified Covered Person must notify the Plan Administrator, or Employer if no Plan Administrator is designated, of the Qualifying Event within 60 days of the event in the case of divorce, legal separation or a child becoming ineligible as a Dependent. If notice is not provided within that time. the right to elect continuation ceases. The Plan Administrator, or Employer if no Plan Administrator is designated, has 14 days after the receipt of this notice to notify the Covered Person of the right to elect continuation.
  
• The Employer must notify the Plan Administrator within 30 days of the date of the Qualifying Event in the case of your death, termination or reduction of your employment or your becoming covered for Medicare benefits. The Plan Administrator has 14 days after the receipt of this notice to notify the Covered Person of the right to elect continuation. In the case where there is no Plan Administrator designated. the Employer has 14 days after the Qualifying Event to notify the Covered Person of the right to elect continuation

Notice mailed to the latest address which the Employer has on record for a qualified Covered Person will constitute required notice. Notice to your former spouse will be deemed notice to all other qualified Covered Persons residing with such spouse on the date the notice is furnished.

If elected, coverage will continue until the earliest of the following:

• The date on which continuation ceases because of failure to pay the required Contribution.
• The date a Covered Person becomes covered under any other group health plan as an employee or otherwise, unless such plan contains an exclusion or limitation provision with respect to any pre­existing condition of the Covered Person. Any benefits will be subject to the Coordination of Benefits provision of this Plan;
• The expiration of 18 months from the date of the Qualifying Event* if the event is termination or reduction of your employment. However, continuation may be extended an additional 11 months if:
  • A Covered Person is determined to have been disabled under titles" or XVI of the Social Security Act on or within 60 days after the date of the Qualifying Event;
• Notice is furnished to the Employer within 60 days of the date of such determination and prior to the end of the 18th month; and
• The appropriate additional contribution is paid for all months after the 18th;
• The date on which it is determined that the Covered Person is no longer disabled under titles II or XVI of the Social Security Act if the person's Qualifying Event was termination or reduction of your employment and if continuation has been extended beyond 18 months. Notification should be made to the Employer within 30 days of any final determination that the person is no longer disabled under titles 11 or XVI of the Social Security Act;
• The expiration of 36 months from the date of the Qualifying Event* if the event was:
  • Your death;
  • Your divorce or legal separation;
  • Your Dependent's loss of coverage because You became covered for Medicare benefits; or
  • A Dependent child ceasing to be a Dependent as defined in this Plan;
• The date on which a person who has elected continuation becomes covered for benefits under Medicare; or
• The date on which this Plan is terminated in its entirety.

When the period of continued coverage ends, the Covered Person may have the right to convert coverage under this Plan. (Call Insurance Company for conversion privilege information.)

*If this expiration date would cause the coverage to terminate on a date other than the last day of a calendar month, coverage will continue until the last day of that month.

Please visit the Department of Labor for more information on Cobra - Continuation of Health Coverage

PRIVACY NOTICE

With a few exceptions, you are entitled to be informed about the information U.T. San Antonio collects about you. Under Sections 552.021 and 552.023 of the Texas Government Code, you are entitled to receive and review this information. Under Section 559.004 of the Texas Government Code, you are entitled to have U.T. San Antonio correct information about you that is held by us and that is incorrect, in accordance with the procedures set forth in the University of Texas System Business Procedures Memorandum 32. The information that U.T. San Antonio collects will be retained and maintained as required by Texas records retention laws (Section 441.180 et seq. of the Texas Government Code) and rules. Different types of information are kept for different periods of time.