COBRA
Employee or Dependents Right To Self Pay

COBRA requires that health care benefits be continued after terminations or other qualifying events if the employee or dependents choose to personally pay for the benefit.

As a participant of this Fund, you have a right to choose this continuation coverage if you lose your health coverage because of a qualifying event such as a reduction in your hours of employment or the termination of your employment. You may elect to continue coverage for yourself and enrolled family members up to 18 months.

If you are the spouse of an employee covered by this Fund, you have the right to choose continuation coverage for yourself if you lose health coverage under the Fund up to 36 months for any of the following reasons:

1. The death of your spouse;

2. A termination of your spouse's employment or loss of eligibility because of a reduction in your spouse's hours of employment;

3. Divorce from your spouse.

If you are a dependent child of an employee covered by this Fund, you have the right to continuation coverage if health coverage under the Fund is lost up to 36 months for any of the following qualifying events:

1. The death of a parent;

2. The termination of a parent's employment or loss of eligibility because of a reduction in parent's hours of employment with his/her employer;

3. Parent's divorce;

4. The dependent ceases to be a "dependent child" under the Fund.

Under COBRA, the employee or a family member has the responsibility to inform the Administrator of the Fund, Southwest Administrators, of a divorce or of a child losing dependent status under the Fund. You have sixty (60) days to notify the Fund from the date of the qualifying event. Your employer has the responsibility to notify the Fund of an employee's death, termination of employment, or loss of eligibility because of a reduction in hours.

Election Period - VERY IMPORTANT - If you miss these dates, you will not be eligible for COBRA.

You must notify the Fund Office if you wish to elect COBRA continuation coverage within sixty (60) days from your qualifying event. You will then have an additional 45 days to pay for your COBRA continuation coverage retroactive to the date of your qualifying event. After the initial payment, you must pay the full cost of the coverage by the 30^th of each month. Coverage will be canceled or denied if your payment is not received within the period specified above.

If you are totally disabled at the time of your COBRA eligibility, the first three months of contributions will be waived by the Fund. All other notice requirements apply.

COBRA continuation coverage will terminate before the end of the 18 months, 29 months or 36 months in any of the following circumstances:

1. You fail to pay the required contribution on time.

2. The individual receiving continuation coverage is covered under any other group plan (as an employee or otherwise) which does not contain any exclusion or limitation with respect to any pre-existing condition.

3. The plan terminates all group health plans for participants.

4. The individual receiving continued coverage becomes entitled to Medicare. If your dependents are not eligible for Medicare, they have a qualifying event.

If you have a newborn child or have a child placed with you for adoption (for whom you have financial responsibility) while your COBRA continuation coverage is in effect, you may add this child to your coverage. You must notify Southwest Administrators (Plan Administrator) in writing, (click here for address), within 30 days (number of days required under the plan for actives to register new dependents) of the birth or placement in order to add the child to your coverage. Of course, adding a child to your COBRA coverage may cause an increase in your COBRA premiums.

A child born or placed for adoption while you are on COBRA will have the same COBRA rights as your spouse or dependents who were covered by the plan before the event that triggered COBRA coverage. Like all qualified beneficiaries with COBRA coverage, their continued coverage depends on the timely and uninterrupted payment of premiums on their behalf.

Disability after COBRA Continuation Coverage Begins

If the Social Security Administration determines that you (or a member of your family who is also eligible for COBRA continuation coverage) were totally and permanently disabled on the day you lost eligibility for health coverage under the plan as an active employee, or within 60 days after that, you or your disabled family member may elect to keep COBRA coverage for 29 months instead of the usual 18 months. (Previously, this special extension was only available for people who were disabled on the date of the COBRA qualifying event). COBRA premiums are higher for the extra 11 months of coverage.

You or your disabled family member must notify Southwest Administrators (Plan Administrator) in writing of the Social Security disability determination within 60 days of the date it is issued, and before the end of the initial 18 month COBRA coverage period. You or your disabled family member must also notify Southwest Administrators (Plan Administrator) within 30 days of the date of any final determination by the Social Security Administration that you or your family member is no longer disabled. As with all COBRA coverage, a disabled beneficiary's eligibility for this extension depends on the timely and uninterrupted payment of premiums on their behalf.

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