Continuation of Coverage Rights Under COBRA

Employees who lose eligibility for coverage under the District School Board of Pasco County (DSBPC) Group Health Insurance Plan(s), collectively called the “Plan,” due to a reduction in work hours, unpaid leave of absence or termination of employment may continue the the following benefits under COBRA.

1. Group Medical (Includes Pharmacy and Behavioral Health)
2. Group Dental
3. Group Vision
4. Employee Assistance Program
5. Health Reimburse Arrangement (HRA)
6. Medical Flexible Spending Account (FSA)

What is COBRA Continuation Coverage?

COBRA continuation coverage is a continuation of Plan coverage when coverage would otherwise end because of a life event known as a “qualifying event.”  After a qualifying event, COBRA continuation coverage must be offered to each person who is a “qualified beneficiary.”  You, your spouse or your dependent children could become qualified beneficiaries if coverage under the Plan is lost because of the qualifying event.  Under the Plan, qualified beneficiaries who elect COBRA continuation coverage must pay for COBRA continuation coverage. 

What is a Qualifying Event?

If you are an employee, you will become a qualified beneficiary if you lose your coverage under the Plan because one of the following qualifying events occurred:

1. Your hours of employment are reduced and you are no longer employed in a benefit eligible position;
2. You experience an unpaid leave of absence; or
3. Your employment ends for any reason other than your gross misconduct.
4. Sometimes, filing a proceeding in bankruptcy under title 11 of the United States Code can be a qualifying event.

If you are the spouse of an employee, you will become a qualified beneficiary if you lose your coverage under the Plan because one of the following qualifying events occurred:

1. Your spouse dies;
2. Your spouse’s hours of employment are reduced;
3. Your spouse experience an unpaid leave of absence;
4. Your spouse’s employment ends for any reason other than his or her gross misconduct;
5. Your spouse becomes entitled to Medicare benefits (under Part A, Part B, or both); or
6. You become divorced or legally separated from your spouse.

Dependent children of an employee will become qualified beneficiaries if they lose coverage under the Plan because one of the following qualifying events occurred:

1. The parent-employee dies;
2. The parent-employee’s hours of employment are reduced;
3. The parent-employee experience an unpaid leave of absence;
4. The parent-employee’s employment ends for any reason other than his or her gross misconduct;
5. The parent-employee becomes entitled to Medicare benefits (under Part A, Part B, or both);
6. The parents become divorced or legally separated from your spouse; or
7. The child stops being eligible for coverage under the plan as a “dependent child.”

When is COBRA Coverage Available?
The Plan will offer COBRA continuation coverage to qualified beneficiaries only after the Plan Administrator has been notified that a qualifying event has occurred.  When the qualifying event is the end of employment or reduction of hours, death of the employee, commencement of a proceeding in bankruptcy with respect to the employer or the employee’s becoming entitled to Medicare benefits (under Part A, Part B, or both), DSBPC must notify the Plan Administrator of the qualifying event.

You Must Give Notice of Some Qualifying Events
Qualifying beneficiaries must give notice of some qualifying events to the DSBPC’s Employee Benefits, Assistance and Risk Management (EBARM) department at (813) 794-2253.  If you are a qualified beneficiary of the Plan you must give notice to EBARM if you experience any of the following qualifying events within 60 days after the qualifying event occurs.

1. Divorce of legal separation
2. Dependent child lose eligibility for coverage under the Plan
3. Become entitled to Medicare Benefits (Part A, Part B or both)
4. File a proceeding for bankruptcy under title 11

Keep the Plan Informed of Address Changes
In order to protect your family’s rights, you should keep the Plan Administrator informed of any changes in the addresses of family members.  You should also keep a copy, for your record, of any notices that you send to the Plan Administrator.

Plan Contact Information

For more additional information about continuation of coverage under COBRA click here to print a copy of the “Initial Notice of Continuation of Coverage Rights Under COBRA” or a list of frequently asked questions about COBRA.     

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A Message from Mary Tillman

The staff in EBARM wants all employees to be healthy, in mind and body, so they can be ready everyday to do their best for our children. Remember as you access health services that the District is self-insured for all medical, pharmacy and mental health services. Therefore, spend wisely, whenever you can use generics, see a primary care doctor instead of a specialist.

Also, take care of yourself, lose weight if you need to, stop smoking, take your medications as prescribed, and get some exercise. This is all good for your mind, body and wallet.