Under certain circumstances employees, their spouses, and/or their dependent children that lose group benefits under the Smithsonian Institution may elect to continue such coverage under provisions of the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) as amended. Monthly premiums are remitted on a direct pay basis.
Employees and Dependents Eligible for Continuation of Coverage
(1) Employees who terminate employment (except in the case of dismissal for gross misconduct), change to an intermittent tour of duty or a tour of duty of less than 40 hours per pay period, or otherwise lose group coverage due to a change in their benefits eligibility status may temporarily continue coverage for 18 months. This extension includes coverage for the employee's dependents that were enrolled at the time of the qualifying life event.
(2) Spouses and dependents of employees who lose coverage because of separation, divorce, entitlement to Medicare benefits for the covered employee, death of a covered employee, or losws of dependent status may continue coverage for up to 36 months. You will need to report this as a qualifying life event via the online employee self-service portal at http://ielect.Secova.com. Once you report the life event and upload the proof documentation (i.e., divorce decree, death certificate), you may remove the dependent from your medical/dental/vision plans.
NOTE: Dependents of employees may be covered until age 26, regardless of student status.
(3) SI policy allows employees who have been deemed totally disabled according to the Smithsonian Institution's long term disability plan to continue coverage for the entire period of disability. The employee will be required to pay only the employee portion of the premium during the period of disability. If the employee is not deemed disbled under the disability plan, but is eligible to receive Social Security payments due to disability, the employee may continue coverage under COBRA provisions for up to 29 months. Please contact the SAO Benefits Office for additional details.
How to Exercise Your Rights
The participant will be responsible for paying the COBRA premium timely. Unless deemed disabled according to the Smithsonian Institution's disability plan, the premium charged will equal 102% of the total monthly premium. This premium is subject to change annually. You have 60 days from the qualifying life event to elect temporary continuation of coverage. If you do not exercise your rights within the allowed time period or fail to make the required premium payment, you will forfeit your right to continue coverage.
Loss of Coverage
Your continuation coverage ceases upon:
- your failure to make a timely premium payment (within 30 days);
- the date you or your qualified beneficiary obtain coverage under certain other group health plans;
- the date you or your qualified beneficiary become entitled to Medicare benefits;
- the date you reach the end of your maximum eligibility period.