COBRA. Healthcare Continuation COBRA. Table of Contents
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1 COBRA This section describes situations where you can continue healthcare coverage for yourself and your eligible dependents when you are no longer eligible for Health Benefits. Table of Contents Healthcare Continuation COBRA COBRA Period Electing COBRA Coverage Cost When COBRA Ends Notice and Election Procedure For More Information Healthcare Continuation COBRA The federal law COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985) allows you and your covered dependents to pay premiums to continue healthcare coverage after it ends due to certain events. COBRA applies to the medical, prescription drug, dental and vision plans, as well as the Pre-Tax Healthcare Account and the Associate Assistance Program (AAP). COBRA does not apply to any other benefit provided by Honda to you or your family. Same-gender domestic partners do not qualify for COBRA continuation coverage. When you become eligible for COBRA, you may also become eligible for other coverage options that may cost less than COBRA continuation coverage. For example, you may be eligible to buy an individual plan through the Health Insurance Marketplace. By enrolling in coverage through the Marketplace, you may qualify for lower costs on your monthly premiums and lower out-of-pocket costs. Additionally, you may qualify for a 30-day special enrollment period for another group health plan for which you are eligible (such as a spouse s plan), even if that plan generally does not accept late enrollees. COBRA HAM/EGA/HNA 161 January 1, 2014
2 COBRA Period COBRA coverage can continue up to 18, 24, 29 or 36 months depending on the situation. If more than one event applies, the maximum coverage period is 36 months total. For Pre-Tax Healthcare Accounts, if any, COBRA coverage is only extended for the remainder of the calendar year in which the COBRA qualifying event occurs. The following chart shows when you and your dependents may continue healthcare coverage under COBRA and for how long. Maximum Period Coverage Can Continue COBRA Qualifying Event You Spouse Child You lose coverage because: 18 months 18 months 18 months Your hours are reduced Your employment ends for any reason (except gross misconduct) You take a leave of absence for U.S. military service You or your qualified dependent are disabled (as defined by Social Security) when you lose coverage 24 months 24 months 24 months 29 months 29 months 29 months You die N/A 36 months* 36 months* You and your spouse divorce or become legally separated N/A 36 months 36 months You become entitled to Medicare N/A 36 months** 36 months** Your child no longer qualifies as an eligible dependent N/A N/A 36 months * The 36-month COBRA limit is in addition to the first 12 months of coverage paid by Honda. A total of 48 months of healthcare continuation is possible for your dependents in the event of your death. You can also elect medical coverage for your dependents under the Survivor Medical Program in the event of your death (see Survivor Medical Insurance Program in the Supplemental Insurance Plans section). ** If you become entitled to Medicare before the date you end employment (for reasons other than gross misconduct) or your hours are reduced, your spouse and any dependent children are entitled to elect COBRA coverage for up to the greater of 36 months from the date of Medicare entitlement, or 18 months from the date of the termination of employment or reduction of hours. Second COBRA Qualifying Event Extension The 18-month COBRA period may be extended to 36 months for your spouse and dependent children who are qualified beneficiaries if a second qualifying event occurs during the 18- month COBRA continuation period. Second qualifying events include death, divorce, legal separation or your dependent child ceasing to be a dependent under the terms of the plan. However, this extension will only be allowed if the second event would have caused the spouse or dependent child to lose coverage under the plan had the first qualifying event not occurred. To be Note Your Medicare entitlement (Part A, Part B or both) is not considered a second qualifying event for your spouse and dependent children under the Honda plan. granted an extension, the qualified beneficiary must notify the Honda Benefits Service Center at or by calling from 10:00 a.m. - 9:00 p.m. ET, Monday - Friday, within 60 days of the second qualifying event. COBRA HAM/EGA/HNA 162 January 1, 2014
3 Disability Extension The 18-month COBRA continuation period may be extended to 29 months if a qualified beneficiary is determined by Social Security to be disabled at any time before the 60 th day of the COBRA continuation period. This 11-month extension is available to all individuals who are qualified beneficiaries due to a termination or reduction in hours of employment. To be granted this extension, you must notify the Honda Benefits Service Center at or by calling from 10:00 a.m. - 9:00 p.m. ET, Monday - Friday within 60 days of the determination and within the 18-month COBRA continuation period. You must also provide a copy of the notice from the Social Security Administration showing their determination of disability. The disabled individual must also notify the Honda Benefits Service Center within 30 days of any final determination that he or she is no longer disabled. Electing COBRA Coverage Honda s COBRA coverage is administered by the Honda Benefits Service Center and Conexis Benefits Administrators, LP. Honda will notify the Honda Benefits Service Center of a COBRA event due to your reduced hours, terminated employment or death. For all other COBRA events, you or your dependent must notify the Honda Benefits Service Center at or by calling from 10:00 a.m. - 9:00 p.m. ET, Monday - Friday within 60 days of the event. Then, the Honda Benefits Service Center will provide information to you about how to continue and pay for coverage under COBRA. You have 60 days from the date coverage ends or the date of your COBRA notice (whichever is later) to elect continued coverage. If you elect COBRA coverage, you may choose to continue any Health Benefits coverage you had at the time you lost coverage. If coverage is modified for active associates, COBRA coverage will also be modified. If you do not elect COBRA coverage within the 60 days, coverage will end and will not be reinstated. You can also elect to continue deposits to your Pre-Tax Healthcare Account for the remainder of the calendar year with after-tax dollars if the benefit available under the plan is equal to or greater than the contributions you would need to make to continue the coverage. While this gives you continued access to the account, you will lose all tax benefits on your contributions. You, your spouse and dependent children who lose coverage as a result of the COBRA qualifying event are qualified beneficiaries entitled to elect COBRA. A child born to, adopted by or placed for adoption with you during the period of COBRA coverage would also be a qualified beneficiary with a right to COBRA coverage. Each qualified beneficiary has an independent right to elect COBRA coverage. You may elect COBRA coverage on behalf of your spouse, and parents may elect COBRA coverage on behalf of their children. In deciding to elect COBRA coverage, you should know that a failure to continue your group health coverage will affect your future rights under federal law as follows: You can lose the right to avoid having pre-existing condition exclusions applied to you by other group health plans if you have more than a 63-day gap in health coverage. Election of COBRA coverage may help you not have such a gap You will lose the guaranteed right to purchase individual health insurance policies that do not impose such pre-existing condition exclusions if you do not elect and maintain COBRA coverage for the maximum time available to you COBRA HAM/EGA/HNA 163 January 1, 2014
4 You should take into account that you have special enrollment rights under federal law. You have the right to request special enrollment in another group health plan for which you are otherwise eligible (such as a plan sponsored by your spouse s employer) within 30 days after your group health coverage ends because of the qualifying event listed above. You will also have the same special enrollment right at the end of COBRA coverage if you elect and maintain COBRA coverage for the maximum time available to you. Cost You have 45 days from your COBRA election to make the first premium payment. Your first premium payment will cover all periods back to your loss of coverage. Covered persons must pay monthly premiums for coverage. Premiums will be based on the coverage level and group of plans you elect plus 2% for administrative costs. If you extend coverage beyond 18 months due to a disability, premiums for months will include an added 50% surcharge, as permitted under COBRA, to reflect plan cost. COBRA premiums are set each year in January and may be adjusted to reflect changes in the plans or their cost. Pre-Tax Healthcare Account contributions, if any, can be continued with after-tax dollars plus 2% for administration. When COBRA Ends If any of the following occurs, COBRA healthcare coverage will end before the maximum period described in the Maximum Period Coverage Can Continue chart under COBRA Period on page 162: Required premiums are not paid by the due date You, your spouse or your dependent becomes covered under another group health plan after you have made your COBRA election (this does not apply if the new plan has pre-existing condition limits affecting the covered person) You, your spouse or your dependent becomes eligible for Medicare (this only affects the person with Medicare coverage) You, your spouse or your dependent recovers from disability during the 11-month extension period Honda no longer provides healthcare coverage to any of its associates COBRA coverage may also be terminated for any reason the plan would terminate coverage of a participant or beneficiary not receiving COBRA coverage (such as fraud). If your COBRA coverage terminates for any reason, it cannot be reinstated. You may have the right to appeal for certain situations; please contact the Honda Benefits Service Center for more information. COBRA HAM/EGA/HNA 164 January 1, 2014
5 Notice and Election Procedure To protect your family s rights, you should keep the appropriate parties informed of any changes in address, as follows: Associate Address. If your address changes, you should notify the Honda Benefits Service Center as shown below Dependent Address. If your spouse or dependent(s) changes address (to an address other than your address), contact the Honda Benefits Service Center as shown below If you have any questions or need to provide notice or make an election related to your COBRA rights, contact the Honda Benefits Service Center at or by calling from 10:00 a.m. - 9:00 p.m. ET, Monday - Friday. Honda Benefits Service Center P.O. Box 9740 Providence, RI You should also keep a copy for your records of any notices you send to the Honda Benefits Service Center or to the plan administrator. For More Information For more information about COBRA coverage or a copy of the complete COBRA Notice distributed by Honda, contact the Honda Benefits Service Center at or by calling from 10:00 a.m. - 9:00 p.m. ET, Monday - Friday. COBRA HAM/EGA/HNA 165 January 1, 2014
6 COBRA HAM/EGA/HNA 166 January 1, 2014
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