What is COBRA continuation coverage?

COBRA continuation coverage is the same coverage that the Plan provides to other participants or beneficiaries who aren't getting continuation coverage. Each "Qualified Beneficiary" (described below) who elects COBRA continuation coverage will have the same rights under the Plan as other participants or beneficiaries covered under the Plan.

Who are the qualified beneficiaries?

Qualified Beneficiaries are those individuals entitled to elect COBRA continuation coverage. Election Forms included in a notice from ThrivePass will include a complete list of qualified beneficiaries.

COBRA Qualifying Event Types and Coverage Periods

• Employee: Termination for reason other than gross misconduct (18 mos)
• Employee: Reduction of hours (18 mos)
• Retiree: Employer Bankruptcy [*Chapter 11 reorganization if group health plan is continued] (through end of life)
• Dependent Spouse: Death of covered employee (36 mos)
• Dependent Spouse: Divorce or legal separation (36 mos)
• Dependent Spouse: Covered employee becoming entitled to Medicare (36 mos)
• Dependent Child: Loss of dependent status under the group health plan (36 mos)
• Dependent Child: Death of covered employee (36 mos)
• Dependent Child: Covered employee becoming entitled to Medicare (36 mos)

*These reflect maximum continuation coverage periods for most cases. Coverage may be eligible for extension in some cases as a result of a second event or disability. Coverage may also be terminated in advance of the full coverage period being exhausted.

Life Insurance and other State Continuation Coverage

Some coverage is mandated by the state in which the contract is written rather than by federalCOBRA rules. For instance, Minnesota law authorizes an individual to maintain their group life insurance benefits, in an amount equal to the amount of insurance in effect on the date of termination from employment, for a period of up to 18 months. If any plan offered by an employer is mandated by a state, a separate communication will be included with your notice from ThrivePass.

COBRA Continuation Coverage Termination

Continuation coverage is intended to be a short-term solution and will end once the coverage period is exhausted. Other causes for termination include:

• Failure to pay by the end of the grace period
• Fraud
• Removal of group health plan offerings
• You become Medicare eligible
• Coverage started through a new job

If you choose to elect COBRA continuation coverage, use the COBRA Continuation Coverage Election Form included in your mailed notice or log in to elect coverage in your Member Portal.

When does new coverage begin?

Coverage will be reinstated once a completed Election Form is received and the initial payment is processed. At that point, coverage will be reinstated retroactively to the termination date so no lapse in coverage will be reflected.Note, if a partial payment is received, the record is updated but coverage will not be reinstated until the required premium has been paid in full.

How much does COBRA continuation coverage cost?

The monthly cost for COBRA continuation coverage is shown on the Election Form. Other coverage options may cost less.

Paying COBRA Premiums

• Online payments can be made through your Member Portal, which offers the options of one-time payments as well as recurring ACH.
• Check or money order payments should be mailed to the PO Box indicated on your COBRA Continuation Election Form.‍
• The first payment is due in full no later than 45 days after the date your election notice is postmarked.
• Ongoing monthly payments are due on the 1^st of the month with a 30 day grace period to submit payment. Mailed payments must be postmarked within the month the premium is due.

*Checks returned for insufficient funds of that cannot be cashed do not constitute payment and will not extend any payment timelines.

Extending COBRA continuation coverage

If elected, you may be able to extend the length of continuation coverage if a qualified beneficiary is disabled or if a second qualifying event occurs.

• A second Qualifying Event only applies to the spouse or child dependent of a Qualified Beneficiary who experienced a termination or reduction of hours Event.

• The eligible dependent must notify ThrivePass within 60 days of the Second Qualifying Event.

• In the case of disability: within 60 days of determination by the Social Security Administration (SSA), you must notify ThrivePass in writing and submit a copy of the Social Security Disability Award.

• The effective date of disability must be: on or before the 60^th day of COBRA continuation coverage and must last at least until the end of the 18 month period of continuation coverage
• If the SSA determines a Qualified Beneficiary is no longer disabled you must notify ThrivePass within 30 days of the determination.

Keep Your Plan Informed of Address Changes

To protect your and your family's rights, keep the Plan Administrator informed. Notify ThrivePass if :

• you become eligible for other group coverage or Medicare
• your address changes

Other Coverage Options

There may be other coverage options for you and your family through the Health Insurance Marketplace, Medicaid, or other group health plan coverage options (such as a spouse’s plan) through what is called a “special enrollment period.” It is important to choose carefully between COBRA continuation coverage and other coverage options as it can be difficult or impossible to switch to another coverage option once enrolled.

Marketplace and Medicare

What is the Health Insurance Marketplace?

The Marketplace offers “one-stop shopping” to find and compare private health insurance options in order to make an informed decision.

• See if you’re eligible for a tax credit to lower monthly premiums
• See premiums, deductibles, and out-of-pocket costs before enrolling
• Learn if you qualify for free or low-cost coverage from Medicaid or the Children’sHealth Insurance Program (CHIP).

You can access the Marketplace for your state at www.HealthCare.gov.

Coverage through the Health Insurance Marketplace may cost less than COBRA continuation coverage. Being offered COBRA continuation coverage will not limit your eligibility for coverage or a tax credit through the Marketplace.

When can I enroll in Marketplace coverage?

• Anyone can enroll in Marketplace coverage during the open enrollment period.
• Within 60 days of losing job-based coverage

If I sign up for COBRA continuation or Marketplace coverage, can I switch?

Yes, if you have COBRA continuation coverage and become eligible for enrollment in a Marketplace plan during a “special enrollment period.”

• If you have another qualifying event such as marriage or birth of a child.
• If you have exhausted your COBRA continuation coverage and the coverage expires.

If you sign up for Marketplace coverage instead of COBRA continuation coverage, you cannot switch to COBRA continuation coverage under any circumstances.

Enrolling in Medicare instead of COBRA continuation coverage

Generally, if because you are still employed you don’t enroll in Medicare Part A or B when you are first eligible, you have an 8-month special enrollment period to signup, beginning on the earlier of

• The month after your employment ends; or
• The month after group health plan coverage based on current employment ends.

Electing COBRA continuation coverage instead of Medicare

If you don’t enroll in Medicare Part B and elect COBRA continuation coverage instead, you may have to pay a Part B late enrollment penalty and may also have a gap in coverage if you decide you want Part B later.

Electing COBRA continuation coverage and Medicare

If you elect COBRA continuation coverage and then 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 enroll in the other part ofMedicare 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 (primary payer) and COBRA will pay second. Certain COBRA continuation coverage plans may pay as if secondary to Medicare, even if you are not enrolled in Medicare.

More Information

Other sites & resources

• ERISA rights including COBRA: www.dol.gov/ebsa
• Alternate coverage options: www.HealthCare.gov
• Medicare vs COBRA: https://www.medicare.gov/medicare-and-you.

For more information about your rights under the Employee Retirement IncomeSecurity Act (ERISA), including COBRA, the Patient Protection and AffordableCare Act, and other laws affecting group health plans, visit the U.S.Department of Labor's Employee Benefits Security Administration (EBSA) website at www.dol.gov/ebsa or call their toll-free number at1-866-444-3272.

Contacts & addresses

• For Questions about your COBRA options or payment amounts:

• ThrivePass Customer Service email: COBRA@thrivepass.com
• ThrivePass Customer Service phone: 866-855-2844 (Option 3)

• For a copy of your Summary Plan Description:

• Contact your employer’s Human Resources Department

• Premium payments:

• Pay online through the Member Portal
• Check or money order payments should be mailed to the PO Box indicated on your COBRA Continuation Election Form

ThrivePass business hours:

Monday – Thursday: 7:30AM – 5:30PM CT
‍Friday: 7:30AM – 5:00PM CT