and any dependent children getting COBRA continuation coverage if the employee or former employee dies; becomes entitled to Medicare benefits( under Part A, Part B, or both); gets divorced or legally separated; or if the dependent child stops being eligible under the Plan as a dependent child.
This extension is only available if the second qualifying event would have caused the spouse or dependent child to lose coverage under the Plan had the first qualifying event not occurred.
ARE THERE OTHER COVERAGE OPTIONS BESIDES COBRA CONTINUATION COVERAGE? Yes. Instead of enrolling in COBRA continuation coverage, there may be other coverage options for you and your family through the Health Insurance Marketplace, Medicare, Medicaid, Children’ s Health Insurance Program( CHIP) or other group health plan coverage options( such as a spouse’ s plan) through what is called a“ special enrollment period.” Some of these options may cost less than COBRA continuation coverage. You can learn more about many of these options at
www. healthcare. gov.
IF YOU HAVE QUESTIONS Questions concerning your Plan or your COBRA continuation coverage rights should be addressed to the contact or contacts identified below. For more information about your rights under the Employee Retirement Income Security Act( ERISA), including COBRA, the Patient Protection and Affordable Care Act, and other laws affecting group health 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 www. dol. gov / ebsa.( Addresses and phone numbers of Regional and District EBSA Offices are available through EBSA’ s website.) For more information about the Marketplace, visit www. healthcare. gov.
KEEP YOUR PLAN INFORMED OF ADDRESS CHANGES To protect your family’ s rights, let the Plan Administrator know about any changes in the addresses of family members.
You should also keep a copy, for your records, of any notices you send to the Plan Administrator.
PLAN CONTACT INFORMATION Metropolitan Washington Airports Authority Compensation and Benefits Department 1 Aviation Circle Washington, D. C. 20001 703-417-1651 or 703-417-8355
COBRA General Notice
( This notice applies to active employees and retirees.)
Can I enroll in Medicare instead of COBRA continuation coverage after my group health plan coverage ends?
In general, if you don’ t enroll in Medicare Part A or B when you are first eligible because you are still employed, after the Medicare initial enrollment period, you have an 8-month special enrollment period1 to
14 | METROPOLITAN WASHINGTON AIRPORTS AUTHORITY
sign up for Medicare Part A or B, beginning on the earlier of
• The month after your employment ends; or
• The month after group health plan coverage based on current employment ends.
If you don’ t enroll in Medicare and elect COBRA continuation coverage instead, you may have to pay a Part B late enrollment penalty and you may have a gap in coverage if you decide you want Part B later. If you elect COBRA continuation coverage and later enroll in Medicare Part A or B before the COBRA continuation coverage ends, the Plan may terminate your continuation coverage.
However, if Medicare Part A or B is effective on or before the date of the COBRA election, COBRA coverage may not be discontinued on account of Medicare entitlement, even if you enroll in the other part of Medicare after the date of the election of COBRA coverage.
If you are enrolled in both COBRA continuation coverage and Medicare, Medicare will generally pay first( primary payer) and COBRA continuation coverage will pay second. Certain plans may pay as if secondary to Medicare, even if you are not enrolled in Medicare.
For more information, visit https:// www. medicare. gov / medicare-and-you.
ACA Section 1557 Nondiscrimination Statement
( This notice applies to retirees.)
Notice Informing Individuals About Nondiscrimination and Accessibility Requirements and Sample Nondiscrimination Statement: Discrimination is Against the Law
The Metropolitan Washington Airports Authority( the Airports Authority) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. The Airports Authority does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
The Airports Authority:
• Provides free aids and services to people with disabilities to communicate effectively with us, such as qualified sign language interpreters
• Written information in other formats( large print, audio, accessible electronic formats, other formats)
• Provides free language services to people whose primary language is not English, such as qualified interpreters
• Information written in other languages
If you need these services, contact Julius Evans. If you believe that the Airports Authority has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with Julius Evans, EEO and Diversity Program Manager, Metropolitan Washington Airports Authority, EEO and Diversity Program Manager, 1 Aviation Circle, Washington, DC 20001-6000; 703-417-8683; EEO. DiversityPrograms @ mwaa. com. You can file a grievance in person or by mail or email. If you need help filing a grievance, Julius Evans is available to help you.
You can also file a civil rights complaint with the U. S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https:// ocrportal. hhs. gov / ocr / portal / lobby. jsf, or by mail or phone at: U. S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D. C. 20201 1- 800-368-1019, 800-537-7697( TDD) Complaint forms are available at http:// www. hhs. gov / ocr / office / file / index. html.
HIPAA Special Enrollment – Medicaid / CHIP
( This notice applies to active employees.)
If you decline enrollment for yourself or for an eligible dependent( including your spouse) while Medicaid coverage or coverage under a state children’ s health insurance program is in effect, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage. However, you must request enrollment within 60 days after your or your dependents’ coverage ends under Medicaid or a state children’ s health insurance program.
If you or your dependents( including your spouse) become eligible for a state premium assistance subsidy from Medicaid or through a state children’ s health insurance program with respect to coverage under this plan, you may be able to enroll yourself and your dependents in this plan.
However, you must request enrollment within 60 days after your or your dependents’ determination of eligibility for such assistance.
Children’ s Health Insurance Program( CHIP) Notice Premium Assistance Under Medicaid and CHIP
( This notice applies to active employees.)
If you or your children are eligible for Medicaid or CHIP and you’ re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’ t eligible for Medicaid or CHIP, you won’ t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www. healthcare. gov.
If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.
If you or your dependents are NOT currently