You are receiving this notice because you  have recently gained coverage under The City of Jacksonville group health plan(s). This notice contains important information about your right to COBRA continuation coverage, which is a temporary extension of coverage under the Plan. This notice generally explains COBRA continuation coverage, when it may become available to you and your family, and what you need to do to protect the right to receive it. When you become eligible for COBRA, you may also become eligible for other coverage options that may cost less than COBRA continuation coverage. This only applise if you enroll in these plans.

The right to COBRA continuation coverage was created by a federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). COBRA continuation coverage can become available to you  and other members of your family when health group coverage would otherwise end. For additional information about your rights and obligations under the Plan and under federal law, you should review the Plan’s Summary Plan Description or contact the Plan Administrator.

You may  have other options available to you when you lose group health coverage. For example, yuou may be eligible to buy an individual plan through the Health Insurance Marketplace. By enrolling in coverage through the Marketplace, you may qualify for lower cost on your monthly premiums and lower out-of-pocket costs. Additionally, you may qualify for a 30-day special enrollment period for another groupp health plan for which you are eligible (such as a spouse's plan), even if that plan generally doesn't accept late enrollees. 

COBRA continuation coverage is a continuation of Plan coverage when coverage it would otherwise end because of a life event. This is also called a "qualifying event". Specific qualifying events are listed later in this notice. After a qualifying event occurs, COBRA continuation coverage must be offered to each person who is a “qualified beneficiary”. You, your spouse, and your dependent children could become qualified beneficiaries if coverage under the Plan is lost because of the qualifying event. Under the Plan, qualified beneficiaries who elect COBRA continuation coverage must pay for COBRA continuation coverage.

If you are an employee, you will become a qualified beneficiary if you lose your coverage under the Plan because either one of the following qualifying events happens:

If you are the spouse of an employee, you will become a qualified beneficiary if you lose your coverage under the Plan because any of the following qualifying events happens:

Your dependent children will become qualified beneficiaries if they lose coverage under the Plan because any of the following qualifying events happens:

Sometimes, filing a proceeding in bankruptcy under title 11 of the United States Code can be a qualifying event. If a proceeding in bankruptcy is filed with respect to City of Jacksonville, and that bankruptcy results in the loss of coverage of any retired employee covered under the Plan, the retired employee will become a qualified beneficiary with respect to the bankruptcy. The retired employee’s spouse, surviving spouse, and dependent children will also become qualified beneficiaries if bankruptcy results in the loss of their coverage under the Plan.

The Plan will offer COBRA continuation coverage to qualified beneficiaries only after the Plan Administrator has been notified that a qualifying event has occured. The employer must notify the Plan Administrator of the qualifying event when the qualifying event is the end of employment or reduction of hours of employment, commencement of a proceeding in bankruptcy with respects to the employer, death of the employee, or the employee;s becoming entitled to Medicare benefits (under Part A, Part B, or both).

For the other qualifying events (divorce or legal separation of the employee and spouse or a dependent child’s losing eligibility for coverage as a dependent child), a COBRA election will be available to you only if you notify the Plan Administrator within 60 days after the qualifying event occurs. You must provide this notice to TASC Customer Care (800) 422-4661 or COBRAservice@tasconline.com. A certified copy of your final divorce decree or proof of loss of eligibility for a dependent must be submitted with the notice.

Once the Plan Administrator receives notice that a qualifying event has occurred, COBRA continuation coverage will be offered to each of the qualified beneficiaries. Each qualified beneficiary will have an independent right to elect COBRA continuation coverage. Covered employees may elect COBRA continuation coverage on behalf of their spouses, and parents may elect COBRA continuation coverage on behalf of their children.

COBRA continuation coverage is a temporary continuation of coverage that generally lasts for 18 months due to employment temrination or reduction of hours of work. Certain qualifying events, or a second qualifying event during the initial period of coverage, may permit  a beneficiary to receive a maximum of 36 months of coverage.

There are also ways in which this 18-month period of COBRA continuation coverage can be extended:

If you or anyone in your family covered under the Plan is determined by Social Security to be disabled and you notify the Plan Administrtor in a timely fashion, you and your entire family maybe entitle to get up to an addittional 11 months of COBRA continuation coverage, maximum of 29 months. The disabiity would have to have started at the same time before the 60th day of COBRA continuaiton coverage and must last at least until the end of the 18-month period of COBRA continuation coverage.

If your family experiences another qualifying even during the 18 months of COBRA continuation coverage, the spouse and dependent children in your family can get up to 18 additonal months of COBRA continuation coverage, for a maximum of 36 months, if the Plan is properly notified about the second qualifying event. This extension may be available to the spouse and any dependent children getting COBRA continuation coverage if the employee or former employee dies; becomes entitles to Medicare benefits ( under Part A, Part B, or both); gets divorced or legally separated; of it the dependent child stops being eligible under the Plan as a dependent child.  This extension is only availabe if the second qualifying event would have caused the spouse or dependent child to lose coverage under the Plan had the first qualifying event not occured. 

 

In general, if you don’t enroll in Medicare Part A or B when you are first eligible because you are still employed, after the Medicare initial enrollment period, you have an 8-month special enrollment period  to sign up for Medicare Part A or B, beginning on the earlier of 

If you don’t enroll in Medicare and elect COBRA continuation coverage instead, you may have to pay a Part B late enrollment penalty and you may have a gap in coverage if you decide you want Part B later.  If you elect COBRA continuation coverage and later enroll in Medicare Part A or B before the COBRA continuation coverage ends, the Plan may terminate your continuation coverage.  However, if Medicare Part A or B is effective on or before the date of the COBRA election, COBRA coverage may not be discontinued on account of Medicare entitlement, even if you enroll in the other part of Medicare after the date of the election of COBRA coverage. 
 

Health flexible spending arrangement component 

 

If You Have Questions 

Keep Your Plan Informed of Address Changes 

Contact Information

TASC Customer Care
COBRAService@tasconline.com
(800) 422-4661
Customer service hours are Monday-Friday 8:00am-5:00pm.