Health and Welfare Summary Plan Description
7.3 COBRA and Medicare.
If a covered Employee has a Qualifying Event due to termination of employment or reduction in work hours, and the Qualifying Event occurs less than 18 months after the date the Employee became entitled to Medicare, then the maximum COBRA Coverage period for the Employee's Dependents is extended to the last day of the 36-month period beginning on the date the Employee became entitled to Medicare, while the maximum period of maximum COBRA Coverage period for the covered Employee is 18 months from the Qualifying Event. If a covered Employee has a Qualifying Event due to termination of employment or reduction in work hours and, after the Employee has elected COBRA Coverage and during the first 18 months of such coverage, the Employee first becomes entitled to Medicare, the Employee's COBRA Coverage will end. However, COBRA Coverage with respect to the covered Employee's Dependents who have elected COBRA Coverage will not be terminated due to the Employee's entitlement to Medicare and may continue through the remainder of the 18-month maximum coverage period.
In genereal, if you don't enroll in Medicare Part A or B during the initial enrollment period when you are first eligible because you are still employed, after the initial enrollment period you have an 8-month special enrollment period to sign up for Medicare Part A and B, beginning on the earlier of:
- The month after your employement ends; or
- The month after group health plan coverage based on current employment ends.
If you don't enroll in Medicare and elect COBRA continuation coverage instead, you may have to pay a Part B late enrollment penalty and you may have a gap in coverage if you decide you want Part B later. If you elect COBRA continuation coverage and later enroll in Medicare Part A or B before the COBRA continuation coverage ends, the Plan may terminate your continuation coverage. However, if Medicare Part A or B is effective on or before the date of the COBRA election. COBRA coverage may not be discontinued on account of Medicare entitlement, even if you enrolll in the other part of Medicare after the date of the election of COBRA coverage.
If you are enrolled in both COBRA continuation coverage and Medicare, Medicare will generally pay first as the primary payer and COBRA continuation coverage will pay second as the scondary payer. Certain plans may pay as if secondary to Medicare, even if you are not enrolled in Medicare.
For purposes of this article, "entitled to Medicare" means (i) enrollment in Medicare Parts A or B or (ii) having ESRD and (a) having applied for Medicare Part A, (b) having satisfied any waiting period requirement and (c) being either (1) insured under Social Security, (2) entitled to retirement benefits under Social Security or (3) a spouse or dependent of an individual satisfying either (1) or (2).