General Notice of COBRA Rights

Introduction

In the event you were provided a link to this notice it was as a result of your recent enrollment in which you gained coverage under a group health plan ("Plan") for medical, dental, and/or vision as offered by Dow Aero Logistics, LLC ("Company"). This includes important information such as an explanation of COBRA temporary continuation coverage, your rights for COBRA temporary continuation coverage, and when it may become available to employee’s, their spouse, and/or dependents. This notice will also explain other coverage options that may cost less than COBRA temporary continuation coverage upon reaching eligibility.

What is COBRA temporary continuation coverage?

The right to COBRA temporary continuation coverage was created by federal law via the Consolidated Omnibus Budget Reconciliation Act (COBRA). COBRA temporary continuation coverage is a temporary extension of Plan coverage when it would otherwise be terminated. In order to be eligible for COBRA temporary continuation coverage an employee, their spouse, and/or their dependent shall experience a qualifying event and be considered a qualified beneficiary. In these instances any qualified beneficiary will be offered COBRA temporary continuation coverage. Specific qualified beneficiaries and qualifying events include:

If you’re an employee, you will become a qualified beneficiary if you lose coverage under the Plan for the following qualifying events:

  • Your hours of employment are reduced, or

  • Your employment ends for any reason other than your gross misconduct.

If you’re the spouse of an employee, you will become a qualified beneficiary if you lose coverage under the Plan for the following qualifying events:

  • Your spouse dies;

  • Your spouse’s hours of employment are reduced;

  • Your spouse’s employment ends for any reason other than his or her gross misconduct;

  • Your spouse becomes entitled to Medicare benefits (under Part A, Part B, or both); or

  • You become divorced or legally separated from your spouse.

If you’re the dependent child of an employee, you will become a qualified beneficiary if you lose coverage under the Plan for the following qualifying events:

  • The parent-employee dies;

  • The parent-employee’s hours of employment are reduced;

  • The parent-employee’s employment ends for any reason other than his or her gross misconduct;

  • The parent-employee becomes entitled to Medicare benefits (Part A, Part B, or both);

  • The parents become divorced or legally separated; or

  • The child stops being eligible for coverage under the Plan as a dependent child.

    • e.g. Reaching the age of twenty-six (26) years old.

Under the Plan, qualified beneficiaries who elect COBRA temporary continuation coverage shall be responsible for 102% of the cost of the monthly premiums for their selected coverage(s) offered by the Company. For more information about your rights and obligations under the Plan please review the Summary Plan Description for any enrolled coverage. A Summary Plan Description would have been provided upon enrolling for any coverage. If unavailable you may, as an employee, access these records from the Company’s Human Resources Information System (HRIS). Employee spouse’s or dependent’s may request this information by contacting the Company’s Human Resources department, via any method identified at the end of this notice.

When is COBRA temporary continuation coverage available?

The Company will offer COBRA temporary continuation coverage to qualified beneficiaries automatically upon an employee experiencing the following qualifying event:

  • The end of employment for any reason other than the employee’s gross misconduct

  • The employee’s reduction of hours of employment;

  • The employee’s death;

  • The employee becoming entitled to Medicare benefits (under Part A, Part B, or both).

For all other qualifying events you must notify the Company’s Human Resources department within sixty (60) days after the qualifying event occurs in order for COBRA temporary continuation coverage to be offered to qualified beneficiaries.

How is COBRA temporary continuation coverage provided?

Once the Company’s Human Resources department receives notice that a qualifying event has occurred, COBRA temporary continuation coverage will be offered to each of the qualified beneficiaries. Each qualified beneficiary will have an independent right to elect COBRA temporary continuation coverage. Covered employees may elect COBRA temporary continuation coverage on behalf of their spouses and parents may elect COBRA temporary continuation coverage on behalf of their children.

COBRA continuation coverage is a temporary continuation of coverage that generally lasts for eighteen (18) months due to the employee’s termination of employment or reduction of hours at work. Certain qualifying events, or a second qualifying event during the initial period of coverage, may allow a beneficiary to receive a maximum of thirty-six (36) months of coverage.

There are also ways in which an initial period of COBRA temporary continuation coverage can be extended. These are as follows:

  • Disability extension of 18-month period of COBRA temporary continuation coverage

    • If you or anyone in your family covered under the Plan is determined by the Social Security Administration to be disabled and you have notified the Company’s Human Resources department in a timely fashion, you and your entire family may be entitled to get up to an additional eleven (11) months of COBRA temporary continuation coverage, for a maximum of twenty-nine (29) months. To qualify, the disability would have needed to occur some time before the sixtieth (60th) day of COBRA temporary continuation coverage and must last at least until the end of the initial eighteen (18) month period of COBRA temporary continuation coverage.

  • Second qualifying event extension of 18-month period of continuation coverage

    • If the employee’s family experiences another qualifying event during the initial eighteen (18) months of COBRA temporary continuation coverage, the spouse and dependent children can get up to eighteen (18) additional months of COBRA temporary continuation coverage for a maximum of thirty-six (36) months. Be aware that the Company’s Human Resources department shall be notified in a timely fashion about the second qualifying event in order to be eligible for the extension. This extension may be available to the employee’s spouse and any dependent children getting COBRA temporary continuation coverage if the employee or former employee dies, becomes entitled to Medicare benefits (under Part A, Part B, or both), gets divorced or legally separated, or if the dependent child stops being eligible under the Plan as a dependent child. This extension is only available if the second qualifying event would have caused the spouse or dependent child to lose coverage under the Plan had the first qualifying event not occurred.

Are there other options besides COBRA temporary continuation coverage?

Absolutely! Instead of enrolling for COBRA temporary continuation coverage, there may be other coverage options available to an employee, their spouse, and/or their dependent children through the Health Insurance Marketplace, Medicaid, or other group health plan coverage options which may cost less than COBRA temporary continuation coverage.

By enrolling in coverage through the Health Insurance Marketplace, you may qualify for lower costs on your monthly premiums and lower out-of-pocket costs. You can learn more about the Health Insurance Marketplace at www.HealthCare.gov.

Additionally, you may qualify for a thirty (30) day special enrollment period for another group health plan for which you are eligible (such as the employee’s spouse plan), even if the plan generally does not accept enrollees outside of an open enrollment period. 

If you have any questions

Questions concerning the Plan or about COBRA temporary continuation coverage should be directed to the Company’s Human Resources department. For more information about your rights under the Employee Retirement Income Security Act (ERISA), including COBRA, the Patient Protection and Affordable Care Act, and other laws affecting group health plans contact the nearest Regional or District Office of the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) in your area or visit www.dol.gov/ebsa.

Updating contact information

To protect your rights for COBRA temporary continuation coverage please keep the Company’s Human Resources department informed when there is a change of address, phone number, and/or email address. It is also recommended that you keep a copy, for your records, of any notices you send and receive from the Company’s Human Resources department.

Plan contact information

Dow Aero Logistics - Human Resources

Physical/Mailing Address 6800 Camille Avenue, Oklahoma City, Oklahoma 73149

Phone 1.405.670.6800; 804 | Fax 1.405.671.8055 | Email cobra@dowaero.com