- COBRA (Federal Consolidated Omnibus Budget Reconciliation Act) requires the Welfare Fund to offer members and their families the opportunity to purchase certain benefits.
Important Information
FORMS HOTLINE: 212-539-0539
The election of City (Medical/Hospital) COBRA does not enroll you in UFT Welfare Fund COBRA.
A separate UFT Welfare Fund COBRA application is required.
COBRA provides continuation of Fund coverage when coverage would otherwise end because of a life event known as a “qualifying event.” Specific qualifying events are listed below. COBRA continuation coverage must be offered to each person who is a “qualified beneficiary” (QB). A qualified beneficiary is someone who will lose coverage under the Fund because of a qualifying event. Depending on the type of qualifying event, employees, spouses of employees/domestic partners, and dependent children of employees may be qualified beneficiaries. Qualified beneficiaries who elect COBRA continuation coverage must pay for COBRA continuation coverage.
When am I eligible for COBRA?
Covered members are eligible for continuation under COBRA if Welfare Fund coverage was terminated due to the following qualifying events:
a. a reduction in hours of employment or
b. the termination of employment including deferred payability and retirement.
Termination of employment includes non-covered unpaid leaves of absence of
any kind and cannot be due to gross misconduct.
Spouses/domestic partners of covered members have the right to continue coverage
if coverage is lost for any of the following qualifying events:
1. death of the member; or
2. termination of the member’s employment for any reason other than
his or her gross misconduct; or
3. loss of coverage due to a reduction in the member’s hours of employment;
or
4. divorce or legal separation from the member; or
5. termination of the domestic partnership with the member.
Dependents of members have the right to continue coverage if coverage is lost for any of the following qualifying events:
1. death of the parent-member; or
2. the termination of a parent-member’s employment for any reason other than his or her gross misconduct; or
3. loss of coverage due to a reduction in the parent-member’s in hours of employment; or
4. the dependent ceases to be a “dependent child” under the Fund’s rule of eligibility.
Qualified Beneficiary (QB): Individuals entitled
to COBRA coverage on their own are called qualified beneficiaries (QB).
Individuals who may be qualified beneficiaries are the covered member, the
spouse/domestic partner of the covered member and the dependent child(ren)
of a covered member. In order to be a QB, an individual must be covered
under the UFT Welfare Fund on the day before the event that causes the loss
of coverage. The Health Insurance Portability and Accountability Act (HIPAA)
amended this requirement to allow a child who is born to or adopted by the
covered employee, while on COBRA, to become a Qualified Beneficiary.
NOTES: Individuals covered under another employer sponsored group health plan prior to their COBRA start date are still eligible to purchase UFT Welfare Fund COBRA. However, individuals who become covered under another employer sponsored group health plan while on UFT Welfare Fund COBRA may not be eligible to continue the UFT Welfare Fund COBRA (except for the period that the new health plan excludes pre-existing conditions).
The Fund offers Medicare eligible enrollees and/or their Medicare eligible dependent(s) continuation benefits similar to COBRA if a COBRA event should occur.
What are the periods of continued coverage?
Continuation of coverage is available for a maximum duration of eighteen
(18) months for the former member and their eligible dependents as a result
of:
1. termination of employment; or
2. reduction of hours of employment; or
3. loss/reduction of Fund benefits due to deferred payability and retirement.
Continuation of coverage is available for a maximum duration of thirty-six (36) months for the member’s eligible dependents as a result of:
1. death of member; or
2. divorce; or
3. legal separation; or
4. termination of a domestic partnership; or
5. dependents who cease to be a “dependent child” under the Fund’s rules of eligibility.
COBRA premiums for eighteen (18) or thirty-six (36) month policies are calculated at 102% of the employer’s cost for coverage to the plan at the group rate.
What is the “Disability Extension beyond the 18-month Period of
Continuation
Coverage”?
If you or anyone in your family covered under the Fund is determined by the Social Security Administration (SSA) to be disabled prior to the COBRA event date and/or at any time during the first sixty (60) days of COBRA continuation coverage, and you notify the Fund in a timely fashion, you and your entire family can receive up to an additional eleven (11) months of COBRA continuation coverage, for a maximum of twenty-nine (29) months. You must make sure that the Fund is notified of the Social Security Administration's determination by sending a copy of the Determination letter within sixty (60) days of the date of the determination and before the end of the eighteen (18) month period of COBRA continuation coverage. This notice should be sent to the UFT Welfare Fund at 52 Broadway, New York, New York 10004, Attention: COBRA.