Metropolitan Washington Airports Authority Privacy Officer 1 Aviation Circle Washington, DC 20001-6000 703-417-8357 privacy. officer @ mwaa. com
To file a complaint with the Department of Health and Human Services, please direct correspondence to:
Department of Health and Human Services, Office for Civil Rights 200 Independence Avenue, SW Washington, DC 20201 Phone: 1-877-696-6775 Web: http:// www. hhs. gov / ocr / privacy / hipaa / complaints /
All complaints, whether submitted to the Airports Authority Privacy Officer or the Department of Health and Human Services, must be made in writing. You will not be penalized or otherwise retaliated against for filing a complaint.
CHANGES TO THIS NOTICE The Airports Authority may change the terms of this notice and privacy policies at any time. The revised or changed policies will be effective for all PHI maintained at that time as well as for PHI received in the future.
Continuation Coverage Rights Under COBRA
As a participant in the Airports Authority’ s benefits( comprised of medical, dental, vision, and Health Care FSA plans), you are receiving this notice that describes your right to COBRA continuation coverage.
COBRA, or the Consolidated Omnibus Budget Reconciliation Act of 1985, is a federal law affecting most employers who offer group health coverage to their employees. Under this law, you and other members of your family may have the right to temporarily continue the group health benefits when you would ordinarily lose coverage. This document describes your right to this COBRA continuation coverage, when it may become available to you and your family and what you must do to protect your right to receive it.
WHAT IS COBRA CONTINUATION COVERAGE? COBRA continuation coverage is a continuation of Plan coverage when it would otherwise end because of a life event. This is also called a“ qualifying event.” Specific qualifying events are listed later in this notice. After a qualifying event, COBRA continuation coverage must be offered to each person who is a“ qualified beneficiary.” You, your spouse, and your dependent children could become qualified beneficiaries if coverage under the Plan is lost because of the qualifying event. Under the Plan, qualified beneficiaries who elect COBRA continuation coverage must pay for COBRA continuation coverage.
If you’ re an employee, you’ ll become a qualified beneficiary if you lose your coverage under the Plan because of the following qualifying events:
• Your hours of employment are reduced, or
• Your employment ends for any reason other than your gross misconduct.
If you’ re the spouse of an employee, you’ ll become a qualified beneficiary if you lose your coverage under the Plan because of the following qualifying events:
• Your spouse dies;
• Your spouse’ s hours of employment are reduced;
• Your spouse’ s employment ends for any reason other than his or her gross misconduct;
• Your spouse becomes entitled to Medicare benefits( under Part A, Part B, or both); or
• You become divorced or legally separated from your spouse.
Your dependent children will become qualified beneficiaries if they lose coverage under the Plan because of the following qualifying events:
• The parent-employee dies;
• The parent-employee’ s hours of employment are reduced;
• The parent-employee’ s employment ends for any reason other than his or her gross misconduct;
• The parent-employee becomes entitled to Medicare benefits( Part A, Part B, or both);
• The parents become divorced or legally separated; or
• The child stops being eligible for coverage under the Plan as a“ dependent child.”
Sometimes, filing a proceeding in bankruptcy under title 11 of the United States Code can be a qualifying event. If a proceeding in bankruptcy is filed with respect to the Airports Authority, and that bankruptcy results in the loss of coverage of any retired employee covered under the Plan, the retired employee will become a qualified beneficiary. The retired employee’ s spouse, surviving spouse, and dependent children will also become qualified beneficiaries if bankruptcy results in the loss of their coverage under the Plan.
WHEN IS COBRA CONTINUATION COVERAGE AVAILABLE? The Airports Authority medical plan( the Plan) will offer COBRA continuation coverage to qualified beneficiaries only after the Plan Administrator has been notified that a qualifying event has occurred. The employer must notify the Plan Administrator of the following qualifying events:
• The end of employment or reduction of hours of employment;
• Death of the employee;
• Commencement of a proceeding in bankruptcy with respect to the employer; or
• The employee’ s becoming entitled to Medicare benefits( under Part A, Part B, or both).
For all other qualifying events( divorce or legal separation of the employee and spouse or a dependent child’ s losing eligibility for coverage as a dependent child), you must notify the Plan Administrator within 60 days after the qualifying event occurs. You must provide this notice to:
Metropolitan Washington Airports Authority Compensation and Benefits Department 1 Aviation Circle Washington, D. C. 20001
HOW IS COBRA CONTINUATION COVERAGE PROVIDED? Once the Plan Administrator receives notice that a qualifying event has occurred, COBRA continuation coverage will be offered to each of the qualified beneficiaries. Each qualified beneficiary will have an independent right to elect COBRA continuation coverage.
Covered employees may elect COBRA continuation coverage on behalf of their spouses, and parents may elect COBRA continuation coverage on behalf of their children.
COBRA continuation coverage is a temporary continuation of coverage that generally lasts for 18 months due to employment termination or reduction of hours of work. Certain qualifying events, or a second qualifying event during the initial period of coverage, may permit a beneficiary to receive a maximum of 36 months of coverage.
There are also ways in which this 18-month period of COBRA continuation coverage can be extended:
DISABILITY EXTENSION OF 18-MONTH PERIOD OF COBRA CONTINUATION COVERAGE If you or anyone in your family covered under the Plan is determined by Social Security to be disabled and you notify the Plan Administrator in a timely fashion, you and your entire family may be entitled to get up to an additional 11 months of COBRA continuation coverage, for a maximum of 29 months. The disability would have to have started at some time before the 60th day of COBRA continuation coverage and must last at least until the end of the 18-month period of COBRA continuation coverage. If you or a covered beneficiary is determined disabled by Social Security, you must notify the Plan Administrator, in writing, within 60 days of the determination by Social Security.
SECOND QUALIFYING EVENT EXTENSION OF 18-MONTH PERIOD OF CONTINUATION COVERAGE If your family experiences another qualifying event during the 18 months of COBRA continuation coverage, the spouse and dependent children in your family can get up to 18 additional months of COBRA continuation coverage, for a maximum of 36 months, if the Plan is properly notified about the second qualifying event. This extension may be available to the spouse
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