“Qualifying Events” are certain events that cause an individual to lose health care coverage. Qualifying Events that trigger your right to COBRA coverage are:

• Voluntary or involuntary termination of the covered employee’s employment for reasons other than “gross misconduct”;
• Reduced hours of work for the covered employee, resulting in ineligibility for health coverage;
• Divorce or legal separation of the covered employee;
• Death of the covered employee;
• Loss of status as an “eligible dependent child” under plan rules;
• The covered employee becomes entitled to Medicare, resulting in ineligibility for coverage; or
• The employer files a Chapter 11 bankruptcy (only applicable to retired employees and their dependents covered under a retiree medical program).

The Qualifying Event you experience determines your notice requirements and the amount of time you may retain COBRA coverage.

You, your spouse, or dependent child must notify Pasco County Schools’ Employee Benefits Office of a divorce or a child losing dependent status within 60 days of the event. (The Plan is required to provide notice to you and/or your enrolled dependents of the right to elect COBRA coverage due to any of the other Qualifying Events.)

To provide this notice, you may email your written notice to Employee Benefits at mybenefits@pasco.k12.fl.us or fax to (813) 794-2173. Alternatively, your spouse or dependent child may give written notice of the Qualifying Event to Employee Benefits. The written notice must provide the individual’s name and current mailing address, the specific Qualifying Event and the date of the Qualifying Event.

If written notice is not provided to Employee Benefits within 60 days after the date of the Qualifying Event, all rights of that individual to elect COBRA coverage will be lost.

If you are enrolled in COBRA coverage and experience a Second Qualifying Event or are determined by the Social Security Administration to be disabled, you must also notify Employee Benefits.

The length of COBRA coverage offered depends on your Qualifying Event.

• If the Qualifying Event is termination of employment or a reduction of work hours, Qualified Beneficiaries are given the opportunity to continue COBRA coverage for 18 months.

• If a Qualified Beneficiary is determined to have been disabled on the date of the Qualifying Event or during the first 60 days of COBRA coverage, additional coverage may be available; however COBRA coverage will never be extended beyond 36 months of the date of the original Qualifying Event.

• If the Qualifying Event is death of the covered employee, divorce or legal separation, or loss of dependent status, COBRA coverage is available for 36 months.

Qualified Beneficiaries have 60 days from the date of the Qualifying Event or if later, from the date of Pasco County Schools’ notice offering COBRA, to elect COBRA coverage. (You are not eligible to elect COBRA coverage if you, your spouse, or dependent child failed to notify the Pasco County Schools’ Employee Benefits Office of a divorce or a child losing dependent status within 60 days of the event.)

If neither you nor your spouse or dependent child(ren) elect COBRA continuation coverage during the applicable election period, your health care coverage will end according to the terms of the Plan.

Eligible COBRA Continuation Benefits

Employees who lose eligibility for coverage under Pasco County Schools Group Health Plan may be eligible to continue the following benefits under COBRA.

• Group Medical (Includes Pharmacy, EAP and Behavioral Health)
• Group Dental
• Group Vision
• Medical Flexible Spending Account (FSA)

Employees who lose eligibility for coverage under Pasco County Schools Group Health Plan may be eligible to continue the following benefits under COBRA.

• Group Medical (Includes Pharmacy, EAP and Behavioral Health)
• Group Dental
• Group Vision
• Medical Flexible Spending Account (FSA)

Your COBRA coverage under the Plan will end for you and/or your enrolled dependents if any of the following occurs:

• The required premium payments are not paid within the timeframe allowed;
• You notify the COBRA administrator that you wish to cancel your coverage;
• The applicable period of COBRA coverage ends;
• You become entitled to Medicare benefits;
• You have extended COBRA coverage due to Social Security disability and a final determination is made that you are no longer disabled, coverage for all who had qualified for the disability extension will end as of the later of:
  • the last day of 18 months of continuation coverage, or
  • the first day of the month that is more than 30 days following the date of the final determination of the non-disability;
• After the date of your COBRA election, you become covered under another group health plan that does not contain any exclusion or limitation for any of your pre-existing conditions (if you become covered by another group health plan with a pre-existing condition limitation that affects you, your COBRA coverage can continue); or
• An event occurs that permits termination of coverage under Pasco County Schools’ Group Health Plan for an individual covered other than pursuant to COBRA (e.g., submitting fraudulent claims).

This web page does not fully describe COBRA coverage. For additional information about your rights and obligations under the Plan and under federal law, you should review the Plan’s Summary Plan Description or contact Employee Benefits.

Pasco County Schools
Attn: Employee Benefits
7227 Land O’ Lakes Blvd
Land O’ Lakes, FL 34638

If you divorce or lose eligibility as a dependent child under Pasco County Schools’ Group Health Plan, you must provide the required written notice to Employee Benefits within 60 days.

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.