If You Lose Health Care Coverage

COBRA: If You and Your Dependents Lose Health Care Coverage

If you lose your BMC medical, dental and vision coverage, in certain situations you may be able to continue coverage on an after-tax basis. This opportunity to continue coverage is provided by the Consolidated Omnibus Budget Reconciliation Act (COBRA), a federal law.

COBRA coverage is a temporary continuation of health care coverage when it otherwise would end because of a life event, known as a “qualifying event.” After a qualifying event, COBRA continuation coverage is offered to each “qualified beneficiary.” You, your spouse/domestic partner and your dependent children could become qualified beneficiaries if coverage under the health care plans is lost because of the qualifying event. You pay a monthly premium for continuation of coverage. BMC does not pay for or contribute toward the premium, so coverage is more expensive than health coverage for active employees.

COBRA applies to these plans:

  • Medical insurance
  • Dental insurance
  • Vision insurance
  • Health Care Flexible Spending Account
  • Employee Assistance Program

For additional information about your rights and obligations under federal law and under BMC’s group health care plans—medical (including prescription drugs), dental and vision coverage and the Health Care FSA—contact Your Benefits Resources (YBR) Benefits Center at 1-877-BMC-4849.

Coverage Options

When you or a qualified beneficiary chooses to continue coverage, coverage options include:

  • Keep the same level of coverage you had as an active employee or choose a lower level of coverage
  • Change coverage (if enrolled within the initial 60-day enrollment window) in either of the following circumstances:- During the annual enrollment period- If you or your dependent has a qualified status change (life event) or another change in circumstances recognized by the Internal Revenue Service (IRS) and BMC
  • Enroll any newly eligible spouse or dependent child under the health care plan’s rules

When can I elect COBRA coverage?

The following charts show how long you and your eligible dependents (qualified beneficiaries) can continue COBRA coverage.

If you lose coverage because....

You are no longer eligible due to termination of your employment or your work hours are reduced below 30 regularly scheduled hours per week.

You can continue coverage for...

18 months

If you lose coverage because....

You are no longer eligible due to termination of your employment and either you or a dependent is disabled (according to the Social Security definition) at any time during the first 60 days of COBRA coverage.

You can continue coverage for...

29 months

When Your Age 26 Dependent Loses Health Care Coverage

Health care coverage for your dependent child will end on the last day of the month in which he or she turns age 26. Your child can remain covered under the BMC group health care plans for up to 36 months through COBRA by enrolling in single coverage and paying the full premium. You will receive COBRA information in the mail automatically when your dependent turns age 26.

Ending Coverage

COBRA coverage under a group health care plan ends before the maximum continuation period if:

  • You or your covered dependent fails to make timely premium payments or contributions
  • You or your covered dependent become entitled to Medicare
  • You or any of your covered dependents become covered under another health care plan not offered by the company
  • During an extended period of COBRA coverage due to a disability (and assuming there has not been a second qualifying event), a final determination is made by the Social Security Administration that the qualified beneficiary is no longer disabled

For more information about your rights under the Employee Retirement Income Security Act of 1974 (ERISA), including COBRA, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and other laws affecting group health care 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 the EBSA website. (Addresses and phone numbers of regional and district EBSA offices are available through EBSA’s website).