Health & Welfare and Pension Funds
of Philadelphia and Vicinity

COBRA

The purpose of COBRA is to allow an eligible member or their dependents the opportunity to continue their coverage themselves should they lose coverage under the Funds various rules and regulations. This extension applies to you and your dependents if you and they were covered by the Fund on the day before your or their coverage ended.

Questions regarding your eligibility for COBRA coverage should be directed to the Fund's COBRA Department, either by e-mail, snail mail or telephone.

General COBRA Notice

Federal Law (P.L. 99-272, Title X) requires that most group health plans offer employees and their families the opportunity for a temporary extension of health coverage (called "continuation coverage") at group rates in certain instances where coverage under the plan would otherwise end. This law became effective July 1, 1988 for this Fund. This notice is intended to inform you, in a summary fashion, of your rights and obligations under the continuation coverage provisions of the Federal law and under the Fund's Plan. Both you and your spouse should take the time to read this notice carefully.

If you are a member covered by the Teamsters Health & Welfare Fund of Philadelphia and Vicinity (the "Fund"), you have the right to choose this continuation coverage if you lose your group health coverage because of a reduction in hours of employment or termination of your employment (for reasons other than gross misconduct on your part).

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

1. The death of your spouse; 
2. A termination of your spouse's employment (for reasons other than gross misconduct) or reduction in your spouse's hours of employment; 
3. Divorce or separation from your spouse; or 
4. Your spouse becomes eligible for Medicare benefits.

In the case of a dependent child of an employee covered by the Fund, he or she has the right to continuation coverage if group health coverage under the Fund is lost for any of the following five reasons:

1. The death of a parent; 
2. A termination of your parent's employment (for reasons other than gross misconduct) or reduction in your parent's hours of employment; 
3. Parent's divorce or separation; 
4. A parent becomes eligible for Medicare benefits; or 
5. The dependent ceased to be a "dependent child" under the Fund's Plan of Benefits.

Under this Federal law, the member or family member has the responsibility to inform the Fund Administrator of a divorce, separation, or a child losing dependent status under the Fund's Plan within sixty (60) days of the later of the event or the date on which coverage would end under the Plan because of the event. Your employer has the responsibility to notify the Fund Administrator of the member's death, termination of employment or reduction in hours, or entitlement to Medicare benefits. Similar rights may apply to retirees and their spouses and dependent children if their employer commences a bankruptcy proceeding.

Once the Fund Administrator is notified that one of these events has happened, he will in turn notify you that you have the right to choose continuation coverage. Under the law, you have sixty (60) days from the date you are notified by the Fund Administrator of your right to choose continuation coverage to inform the Fund Administrator that you want such coverage. If you do not choose continuation coverage, your group health coverage by the Fund will end.

If you choose continuation coverage, upon your payment of the appropriate premium, the Fund is required to give you health coverage which, as of the time coverage is being provided, is identical to the coverage provided under the Fund's Plan to similarly situated members or family members. However, such coverage does not include weekly disability or death benefits. The law requires that you be afforded the opportunity to maintain continuation coverage for a period of thirty-six (36) months unless you lost group health coverage because of a termination of employment (for reasons other than gross misconduct) or reduction in hours of employment. In that case, the required continuation coverage period is eighteen (18) months. This eighteen (18) month period may be extended to a maximum of thirty-six (36) months if other events (such as death, divorce or separation) occur during that eighteen (18) month period. Additionally, the eighteen (18) month period may also be extended (with a higher premium) up to twenty-nine (29) months in the event of disability (for Social Security purposes).

The law also provides that your continuation coverage may be cut short for any of the following reasons:

1. Your employer no longer provides group health coverage to any of its employees under the Fund's plan;
2. The premium for your continuation coverage is not paid on time; 
3. You become covered under a group health plan other than the Fund's plan that does not contain any exclusion or limitation for a pre-existing medical condition that is actually applied by that other plan; 
4. You become eligible for Medicare benefits; or 
5. This Plan is terminated.

You do not have to show that you are insurable to choose continuation coverage. However, under the law you must pay the premium for your continuation coverage. The premium is intended to reflect the Fund's actual cost of providing the coverage and may not match the contribution rate paid by your Employer. There is a grace period of at least thirty (30) days for payment of the regularly scheduled premium.

Please read all of this information carefully. If you have any questions concerning continuation coverage, please call the Fund office and ask to speak to the COBRA Department. Also, so that you receive all appropriate notices in a timely fashion, it is most important that you notify the Fund office if you have changed your marital status, or you and your spouse have changed your address, or your addresses are different.

 Last Date Updated :  04/28/09