Active Health COBRA FAQs

  1. Provide a common example of a situation, which might occur, causing me to lose my eligibility for benefits under the Trust.

    Your eligibility terminates because you are no longer working the required hours to maintain eligibility under the Plan. This event would qualify you to continue coverage under COBRA by making a self-payment.
  2. How long are my COBRA benefits available?

    A qualified participant is entitled to 18 months, or up to 36 months under Cal-COBRA if enrolled in Kaiser or UnitedHealthcare, of continued coverage if the qualifying event is termination of employment or a reduction of employment hours. This may be extended 11 months if you are considered disabled under the Social Security Act. Any other qualifying event increases the available coverage term for qualified beneficiaries to 36 months (maximum). Refer to the "Qualifying Events" section in the Summary Plan Description.
  3. I am an employee and make COBRA payments. Are my dependents covered for Plan benefits?

    Yes, provided they are eligible dependents, as defined by the Plan. Refer to section; "Eligibility and General Plan Provisions" subtitle "Eligible Dependents" for a complete description of eligible dependents. Also, children born or adopted during the period of continuation coverage are considered dependents, the same as those of active eligible employees. (However, this applies only if the covered employee elects COBRA coverage during the election period and enrolls the new child upon birth or adoption.)
  4. If I continue coverage under COBRA, can I change my choice of medical Plans?

    Yes, you can change your choice of medical Plans (from among the plans being offered) during the annual open enrollment period. Refer to section, "Rolling Twelve-Month Open Enrollment Procedures" for details on the open enrollment.
  5. What if I shift from active coverage to retiree coverage?

    A shift from active to retiree coverage is an open enrollment right, and you have the same rights that an active employee receiving coverage through employment is entitled to. On this basis, COBRA serves as a bridge to retiree coverage.
  6. How is the COBRA self-payment calculated?

    Under the COBRA law, the Trustees are permitted to base the self-payment on a formula, which is the Plan cost plus 2% for administration. For example, if you are covered under either Kaiser or UnitedHealthcare, your monthly COBRA payment for continuation coverage is based on the applicable HMO premium cost, and prescription drug cost, plus 2% for administration. Note, for a disabled qualified participant, the premium for months 19 through 29 may be no more than 150% of the applicable non-COBRA premium.
  7. How often do I make a COBRA self-payment?

    Payments must be paid monthly.
  8. What is "basic" coverage?

    Basic coverage includes medical (either Kaiser, UnitedHealthcare or Anthem Blue Cross). These medical plans include the prescription drug plan benefits are as described in this SPD.
  9. How much will the COBRA self-payment cost?

    The Board of Trustees have instituted a temporary pilot program, whereby the Health Fund will subsidize a portion of your COBRA payments for the first three (3) consecutive months of continuation coverage. Certain participants and beneficiaries are not eligible for the subsidized COBRA. The self-payment will be $50.00 per month for the first three consecutive months of continuation of your "Basic Coverage" of hospital/medical and prescription drug benefits. Benefits for dental and vision can be added for an additional cost. Thereafter, on the fourth month of continuation coverage, the self-payment will increase to the full amount allowed under COBRA. Life Insurance benefits are not continued by COBRA.
  10. When will I again be eligible for the COBRA self-payment of $50.00 per month?

    After you have reestablished your Hours Bank Reserve to a maximum of 600 hours. The Hours Bank Reserve is explained under the section, "Eligibility & General Plan Provisions" subtitle "Continuation of Eligibility - Hours Bank Reserve".
  11. Will the Trustees always offer the COBRA self-payment of $50.00 for the first three months?

    Not necessarily. The Trust subsidy of COBRA self-payments is not guaranteed, and may be discontinued or reduced at any time with 30 days notice to participants.
  12. Who can pay the cost of my COBRA continuation coverage?

    Of course, you can pay the monthly premium. However, it is also permitted for a third party to pay the premium, such as a hospital or a new employer.