Cobra Continuation Coverage
COBRA, a federal law, allows you and your eligible dependents to continue health care coverage for a limited period at your own expense under certain circumstances when health care coverage would otherwise end under the terms of the Plan.
You do not have to prove that you are in good health to choose COBRA Continuation Coverage, but you do have to meet the Plan’s COBRA eligibility requirements and you must apply and pay for such coverage. Your COBRA rights are subject to change.
Coverage will be provided only as required by law. If the law changes, your rights will change accordingly. In addition, the Fund reserves the right to end your COBRA Continuation Coverage retroactively if you are determined to be ineligible for such coverage.
Under COBRA, you and your covered dependents may continue the same coverage that you had before the COBRA-qualifying event, including:
- Medical coverage (including PPO coverage).
- Hospital coverage.
- Prescription drug coverage.
- Dental coverage.
- Vision coverage.
Notwithstanding the above, COBRA Continuation Coverage does not include “Loss of Time”, "Accidental Death & Dismemberment" or “Death Benefits.”
COBRA-Qualifying Events
For You
COBRA Continuation Coverage is available to you, as a Member, if coverage would otherwise end if:
- Your regularly scheduled hours are reduced so that you are no longer eligible to participate in the Fund’s welfare benefits program, or
- Your Covered Employment ends for any reason other than gross misconduct.
For Your Dependents
COBRA Continuation Coverage is available to your Eligible Dependents if coverage would otherwise end if:
- Your (as the Member) regularly scheduled hours with your Contributing Employer are reduced so that you are no longer eligible to participate in the Fund’s welfare benefits program.
- You (as the Member) end Covered Employment with your Contributing Employer for any reason other than gross misconduct.
- You (as the Member) die, get divorced (or your marriage is civilly annulled), or you become entitled to Medicare (Part A or B, or both) and drop Fund coverage.
- Your dependent child ceases to be eligible for Fund coverage.
How COBRA Continuation Coverage Works
Under COBRA, in order to have a right to elect COBRA Continuation Coverage after your divorce, a child ceasing to be a “dependent child” under the Plan, or if you become disabled (or are no longer disabled) as determined by the Social Security Administration, you (or your family member) are responsible for notifying the Fund Office of these qualifying events.
To this end, you (or your family member) must notify the Fund Office in writing of any of these qualifying events no later than 60 days after the event occurs or 60 days after the date coverage would have been lost under the Plan because of that event, whichever is later (“60-Day Qualifying Event Notice”). That notice should be sent to:
Fund Administrator
Health and Benefit Trust Fund
Local 94-94A-94B, AFL-CIO
337 West 44th Street
New York, NY 10036
(212) 541-9880
The Fund Office will then send you information about COBRA Continuation Coverage.
FAQs
I recently married. How do I add my spouse to my coverage?
You must provide a copy of your marriage certificate within 90 days of marriage to enroll your new spouse with the applicable date (date of marriage). If you fail to do so, within the applicable 90-day period, dependent coverage will not be available under the Plan for your new spouse until the first of the month following the date in which you provide the Fund Office with the required documentation or any other verifying information requested. A Coordination of Benefits Form (COB) must be completed if your spouse has other coverage. You should also visit the Life Events page on this site to see what you need to do for your other benefits.