Coverage terminates:

• for a retiree and covered dependents, when the retiree stops receiving a pension check (including pension suspensions).
• for a spouse, when divorced from a retiree.
• for a domestic partner, when partnership terminates.
• for all dependents, unless otherwise eligible, when the retiree dies.

If both spouses, or your domestic partner, are eligible for City health coverage as either an employee or a retiree, and one is enrolled as the dependent of the other, the person enrolled as dependent may pick up coverage in his/her own name within 30 days if the employee/retiree leaves City employment or dies.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires that the plan administrator issue certificates of group health plan coverage to employees upon termination of employment that results in the termination of group health coverage. Each individual, upon termination, will receive a certificate of coverage from the plan administrator.

If you have waived or cancelled your City health plan coverage and subsequently wish to enroll or reinstate your benefits, your coverage will be effective the first of the month following a 90-day waiting period after receipt of your Health Benefits Application.  This waiting period is waived if the enrollment or reinstatement is the result of a loss of other group coverage.  

If your coverage was terminated due to the suspension of your pension check, the reinstatement of coverage will be effective as of the date your pension is restored.

COBRA Benefits

The Federal Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires that the City offer employees, retirees and their families the opportunity to continue group health and/or welfare fund coverage in certain instances where the coverage would otherwise terminate. The monthly premium will be 102% of the group rate. All group health benefits, including Optional Riders, are available. The maximum period of coverage is 36 months.