The Consolidated Omnibus Budget Reconciliation Act of 1985 requires the District to offer employees and their families the opportunity for a temporary extension of health coverage at group rates in certain instances where coverage under the plans would otherwise end. If an employee is covered by any of the District’s group health plans, they have a right to choose this continuation of coverage if they lose such coverage because of a reduction in hours of employment or the termination of employment (for reasons other than gross misconduct on the part of the employee).
The law requires that the employee, their spouse or their dependent children, where applicable, have the option to elect continuation coverage for a period shown below:
| Person |
Reason for Termination |
Months |
|
Employee
|
Voluntary Termination
|
18
|
|
Employee
|
Involuntary Termination (Except for Gross Misconduct)
|
18
|
|
Spouse
|
Death of Employee
|
36
|
|
Spouse
|
Divorce or Legal Separation
|
36
|
|
Spouse
|
Employee Becomes Eligible for Medicare
|
36
|
|
Dependent Child
|
No Longer Qualifies As Dependent
|
36
|
Continuation of coverage will be at the request and expense of the individual(s) affected by the loss of coverage.
The law also provides that continued coverage for the employee may be terminated prior to the expiration of the 18-month or 36-month period, only under the following circumstances:
- Abolition of all health plans provided to any employee,
- Failure to pay premium or
- Covered under another health plan upon reemployment, remarriage or attainment of Medicare eligibility.