Continuing Coverage

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How Do You Continue Managed Choice POS Coverage
When Are Conversion Rights Available

How Do You Continue Managed Choice POS Coverage

If you leave the company or if your work hours are reduced and you are no longer eligible for benefits, you will have a chance to continue your Managed Choice POS coverage. You would be denied this opportunity only if your employment ended due to gross misconduct. The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) defines the rules for continuation coverage.

There are many circumstances under which health care coverage for you and your enrolled dependents can be continued. If your health care coverage ends for any reason, contact the Vought Benefits Center immediately for more information.

How Does Continuation Coverage Work

If you decide to continue health care coverage under COBRA, it will be effective on the date your employee coverage would otherwise have ended. Coverage will not differ from what you had as an active employee. If you covered your dependents, they are eligible for continuation of health care coverage even if you (the former employee) choose not to continue coverage.

Who Pays the Cost

You pay the cost of continuing your health care coverage. Your cost is the company's cost for the coverage plus any contributions you have been making plus a 2% administration fee.

How Do You Enroll

When you leave the company, the Vought Benefits Center will send you information to your last address of record on continuing coverage. You are responsible for making sure the company knows your address or otherwise how to reach you.

You must remain in the coverage you were enrolled in when you left the company.

How Long Can Coverage Continue

You or your covered dependents must notify the company within 60 days that you wish to continue health care coverage. If you do not respond in that time, you will lose the right to continue coverage.

COBRA allows you to continue your health care coverage for a maximum of 18 months if:

Your employment ends for any reason other than gross misconduct or
Your hours are reduced to the extent you become ineligible for health care benefits.

If your coverage ends because of a layoff, coverage will continue for 30 days, after which you may continue coverage by paying the cost described above for the remaining 17 months.

If you or a dependent child becomes disabled, as defined by the Social Security Administration, you may continue coverage for up to 29 months. To be eligible for the additional 11 months of coverage, you must satisfy the following requirements:

The disability occurred prior to losing coverage under this plan,
The disabled person received a Social Security disability income award prior to the end of the first 18 months of COBRA coverage,
The benefits office received a copy of the Social Security disability award within 60 days of its determination, and
The disabled person continues to be disabled for the additional 11 months.

If the disabled person recovers, coverage will end. The cost for the additional 11 months is 150% of the full cost of coverage.

In the following situations, your spouse or dependent children can continue health care coverage for up to 36 months:

You and your spouse are divorced or legally separated,
You become entitled to Medicare,
Your child reaches the maximum age under which the plan provides benefits, or
You die.

In a divorce or separation, or if a child reaches maximum age for benefits, you, your spouse or your child must notify the Vought Benefits Center within 60 days of the event.

If you die while you are covered by the plan, your covered dependents may purchase COBRA coverage for as long as 36 months. The first 30 days are continued at no cost to your covered dependents.

When Does Coverage End

Health care coverage for you or your dependents cannot continue if:

The covered person becomes covered by another group health care plan unless the new plan excludes a pre-existing condition for which the covered person is being treated.
The covered person becomes eligible for Medicare.
Contributions are not paid on time or within a 30-day grace period.
The company stops providing health care benefits to employees.
You are obligated by law to inform us if you are covered under another group health care plan.

When Are Conversion Rights Available

If you or a dependent is eligible to convert health care coverage, the Vought Benefits Center can give you a form to send to Blue Cross Blue Shield of Illinois for additional information.

If your Managed Choice POS coverage terminates for any reason other than discontinuance of the Managed Choice POS plan or failure to make a contribution when due, you may, subject to established rules, obtain an individual policy of health insurance through Blue Cross Blue Shield of Illinois. The benefits and provisions of the individual health policy are different from those of Managed Choice POS. If you have the right to continue the Managed Choice POS coverage in accordance with COBRA, you may not obtain the individual health policy until the end of the COBRA continuation period.

You must apply for the individual policy and pay the first premium within 31 days of the termination of your Managed Choice POS coverage. You will not be covered under an individual health care policy if you are eligible to be covered under Medicare. You also must have been covered under Managed Choice POS for at least three months.

The conversion right may also apply to certain covered dependents of an employee who dies and for a covered child who ceases to be eligible under Managed Choice POS. The conversion may also apply to a spouse who ceases to be an eligible dependent while the employee remains covered by Managed Choice POS.