| If you involuntarily lose your job or suffer a reduction in | | | | - The group policy must have been delivered or issued |
| work hours that results in a loss of group health | | | | for delivery in Missouri |
| insurance coverage for any reason other than for | | | | - The employee or member of the group with the |
| gross misconduct (the "qualifying event'), and your | | | | health insurance must have been continuously covered |
| former employer has more than 20 employees and | | | | under the group policy for the 3 months immediately |
| you were covered by a group insurance plan, under | | | | prior to the termination of coverage |
| federal law you may be entitled to continue your prior | | | | - The employee or member must request continuation |
| coverage. | | | | of coverage in writing within 31 days of the date that |
| The federal law that applies is called COBRA. | | | | coverage would otherwise terminate |
| To potentially qualify for COBRA coverage, you must | | | | - The spouse of an employee or member whose |
| be: | | | | coverage would otherwise terminate due to divorce or |
| - An employee who had a voluntary or involuntary | | | | the death of the member or employee has the same |
| (other than for gross misconduct) termination of | | | | rights to continuation of coverage as the employee or |
| employment (a "covered employee") | | | | member. |
| - The spouse or dependent child of the covered | | | | Coverage is NOT available to individuals who are or |
| employee | | | | could be covered by Medicare or individuals who are |
| - The widow(er) or orphan of the covered employee | | | | or could be covered by any other insured or uninsured |
| - The former spouse of the employee | | | | arrangement that provides hospital, surgical or major |
| - The child of the former spouse of the employee and | | | | medical coverage for a group of which the individual |
| the employee | | | | was not a covered immediately prior to the termination |
| The cost of insurance coverage under COBRA is a | | | | of coverage. |
| maximum of the premium paid by the employer for | | | | The continuation coverage must include maternity |
| the insurance plus a 2% administrative fee. If the | | | | coverage, if maternity coverage was provided under |
| employer previously subsidized the cost of the | | | | the group plan before, but it need not include dental, |
| insurance, it may - but is not required to --continue to | | | | vision care or prescription drug or any benefit other |
| provide this subsidy. | | | | than hospital, surgical or major medical benefits. |
| The time for which continuation coverage is available | | | | The person electing to continue the coverage must |
| depends on the type of event that triggered the | | | | pay to the policy holder, monthly, the amount of the |
| availability for COBRA coverage: | | | | premium required to maintain coverage. That amount |
| - Employees, dependent children and dependent | | | | cannot exceed the group rate for coverage, but if any |
| spouses can continue coverage for 18 months when | | | | benefits are being excluded, the premium will be |
| the qualifying event is job loss or reduction of work | | | | reduced accordingly. The first premium payment must |
| hours | | | | be given to the group policyholder within 31 days of |
| - Dependent spouses and children can continue | | | | when the coverage would otherwise terminate. |
| coverage for 36 months if the covered employee | | | | The laws regarding the continuation of health insurance |
| becomes eligible for Medicare, there is a divorce or | | | | following the termination of employment or the |
| legal separation or if the child loses dependent status | | | | reduction of work hours resulting in the loss of health |
| In some cases where an individual is not eligible for | | | | insurance coverage are complex and every situation is |
| coverage under COBRA, Missouri law gives the right | | | | different. Do not rely on this summary to make |
| to continue coverage for up to 9 months in certain | | | | decisions: speak to your group health insurance |
| limited circumstances. | | | | administrator of the Missouri Division of Insurance for |
| To qualify for coverage under Missouri law: | | | | advice on your particular situation. |