Proprietary 8-23 WageWorks on a timely basis, even if the periodic notice is not received. Be sure to send the COBRA payments promptly and directly to WageWorks, P.O. BOX 660212, Dallas, TX 75266-0212. Continuation coverage will be automatically terminated if payment is not sent to WageWorks on a timely basis. Filing claims Submit claims for dental and/or vision expenses incurred during COBRA continuation coverage in the same way that you did prior to the qualifying event. When COBRA coverage ends COBRA continuation coverage ends on the earliest of the following dates: n The date a qualified beneficiary becomes covered under another dental and/or vision plan, provided that the plan does not subject the individual to a preexisting condition exclusion or limitation. n The last day of the month for which the qualified beneficiary made a COBRA payment on a timely basis, if the COBRA premium is not paid on a timely basis in the subsequent month. Once coverage is terminated for failure to pay the COBRA premium on a timely basis, continuation coverage cannot be reinstated. n The last day of the 18th or 29th or 36th month of the continuation coverage period (whichever applies). n The date that the qualified beneficiary becomes covered by Medicare. n The date the Farmers Agent Group Benefits Program no longer offers dental, or vision care coverage for active agents, district managers and staff members of agents and district managers. If you have questions Questions concerning your Plan or your COBRA continuation coverage rights should be addressed to the contact or contacts identified below. For more information about your rights under the Employee Retirement Income Security Act (ERISA), including COBRA, the Patient Protection and Affordable Care Act, and other laws affecting group health plans, contact the nearest Regional or District Office of the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) in your area or visit www.dol.gov/ebsa. (Addresses and phone numbers of Regional and District EBSA Offices are available through EBSA’s website). For more information about the Marketplace, visit www.healthcare.gov. Keep your Plan informed of address changes To protect your family’s rights, let the Plan Administrator know about any changes in the addresses of family members. You should also keep a copy, for your records, of any notices you send to the Plan Administrator. 43
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