Proprietary 8-22 42 COBRA coverage choices Qualified beneficiaries who lost coverage through the Farmers Agent Group Benefits Program as a result of a qualifying event may elect continuation coverage. Each qualified beneficiary may separately elect COBRA coverage for himself or herself. Alternatively, one qualified beneficiary may elect COBRA coverage for the entire family. During the 60-day COBRA election period, the qualified beneficiaries may only elect the dental and/or vision plan(s) in which they were enrolled on the day prior to the qualifying event. The qualified beneficiaries may discontinue any coverage by not choosing them as part of the COBRA election. During the plan’s annual enrollment period, however, qualified beneficiaries may change their coverages, elect new dental and/or vision coverages, and add or delete dependents, in the same way as similarly situated active participants in the Farmers Agent Group Benefits Program. Changes are not allowed at any other time unless a change in status has taken place, and the change is consistent with the change in status, or an event takes place that enables the qualified beneficiary to have a special enrollment period (see page 37). COBRA coverage premium The COBRA election package will show the current premiums for the dental and/or vision plans in which the qualified beneficiaries were enrolled prior to the qualifying event (i.e., dental, and/or vision coverage). Continuation coverage is on a self-pay basis. Unless specified otherwise, the cost of continuation coverage is 102% of the total premium rate for the coverage. How to pay for COBRA coverage The initial COBRA payment is due on the date when the completed COBRA election form is sent to WageWorks, subject to a grace period of 45 days. The initial COBRA payment must include all retroactive premiums due. If the COBRA election form is sent to WageWorks without the initial COBRA payment, continuation coverage is not effective unless the retroactive and current monthly premiums are sent to WageWorks on a timely basis. After the due date for the initial COBRA premium, all subsequent COBRA premiums are due on the first day of each month, subject to a grace period of 31 days. Failure to send the initial COBRA premium or a subsequent monthly COBRA premium to WageWorks by the end of the applicable grace period will result in the loss of all rights to continuation coverage, retroactive to the last day for which continuation coverage has been paid for on a timely basis. WageWorks will periodically send the qualified beneficiary who elected COBRA coverage a notice regarding the COBRA premiums that are due. The qualified beneficiaries are responsible, however, for making sure that the COBRA payments are sent to
RkJQdWJsaXNoZXIy NzQzMzY=