Coverage for you and/or your family members ends on the earliest of the following dates:
- The last day of the month in which:
- You terminate employment (except as a retiree or due to disability);
- You elect not to participate;
- A family member ceases to be eligible (for example, a child reaches age 26); or
- A retiree becomes a suspended retiree.
- You are no longer eligible for benefits under this Plan (e.g., employment classification changes from "regular employee" to "non-regular employee" or from non-represented to represented where you are no longer eligible for this Plan);
- You do not make any required contribution;
- A Qualified Medical Child Support Order is no longer in effect for a covered family member;
- The date:
- You die;
- The Vision Plan ends;
- Your employer discontinues participation in the Plan.
You are responsible for ending coverage with Benefits Administration when your enrolled spouse or family member is no longer eligible for coverage. If you do not complete your change within 60 days, any contributions you make for ineligible family members will not be refunded.
Loss of eligibility
Everyone in your family may lose eligibility for plan coverage, and you may be subject to disciplinary action up to and including termination of employment if you commit fraud against the Plan, for instance, by filing claims for benefits to which you are not entitled. Coverage may also be terminated if you refuse to repay amounts erroneously paid by the Plan on your behalf or that you recover from a third party. Your participation may be terminated if you fail to comply with the terms of the Plan and its administrative requirements. You may also lose eligibility if you enroll persons who are not eligible, for instance, by covering children who do not meet the eligibility requirements or you do not cancel coverage for a family member at the time they are no longer eligible. (e.g. divorced spouse.)
Extended benefits at termination
You are entitled to extended coverage for as much as a year if you are terminated due to disability with fewer than 15 years of service. This coverage is provided at no cost to you. This is considered a portion of the COBRA continuation period. In order to assure coverage beyond this extension period, you must elect COBRA upon termination of employment.
Several conditions must be met:
- The disability must exist when your employment terminates.
- The extension lasts only as long as the disability continues, but no longer than 12 months.
- This extension applies only to the employee who is terminated because of a disability. Continuation coverage for eligible family members may be available through COBRA.