Please click here for information on Open Enrollment for Continuants, COBRA and Retirees.   

The right to COBRA continuation coverage was created by a federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA).  COBRA continuation coverage is available to you when you would otherwise lose your group health coverage.  It is also available to other members of your family who are covered under the Plan when they would otherwise lose their group health coverage.  For additional information about your rights and obligations under the Plan and under federal law, contact the Employee Benefits office.

The notice below contains important information about your right to COBRA continuation coverage, which is a temporary extension of coverage under the Plan.  This notice generally explains COBRA continuation coverage, when it may become available to you and your family, and what you need to do to protect the right to receive it. 

• View Notice of Continuation Coverage Rights Under COBRA

Under COBRA, you are offered the same coverage you had as an employee (Personal Choice or Keystone).  Personal Choice subscribers are offered the options to downgrade to the less expensive Keystone HMO.  For PFT, District 1201 and Local 634 employees, Prescription, Vision and Dental coverage are administered by your Health and Welfare Fund. 

Are there alternatives to COBRA?

Yes.  Click here for more information.

Further down:

• Eligibility
• PA Acts 110/43 

Length of time of COBRA coverage for employees

COBRA RATES - Adjust Annually as of July

 COBRA and Retiree Rider (Prescription /Vision and Dental) Rates

 * dental rates adjust each December.

Eligibility

Below is the general guideline Employee Benefits uses to determine eligibility for our under 65 Medical Groups.

Employees, who resign, are terminated or retire and are NOT eligible for PA Acts 110/43, are offered COBRA for 18 months.  Once they leave our COBRA group, they cannot return.

If an Employee is eligible under PA Acts 110/43, they and their spouse may continue in the SDPs under 65 medical plan (COBRA) to which they were entitled as an employee, until they are Medicare eligible.

If they do not elect our COBRA upon retirement or later drop our coverage to be covered under another employer group, they may elect to enroll in the SDPs group, with no break in coverage from their former coverage, if they experience a Qualifying Event (QE) as explained below and provide documentation to the SDP within 60 of the QE.

If a couple can demonstrate that at one time, both were employees of the SDP, they may elect to enroll in 2 single policies, each with eligibility until age 65; otherwise, they must enroll as a couple.

Qualifying Events include:

• Your retirement
• Your involuntary loss of health care coverage under a non-public school employer's health plan (including COBRA continuation coverage) Your or your spouse's attainment of age 65 or eligibility for Medicare
• A change in your family status (including divorce, your death, death of a spouse, addition of a dependent through birth, adoption, or marriage, or loss of a dependent through loss of eligibility)
• Your eligibility for Premium Assistance due to a change in legislation
• Termination of a plan approved for Premium Assistance

Qualifying Events apply to your spouse as well as to you.  

PA Acts 110 / 43

Two acts of the Pennsylvania State Legislature go beyond COBRA to provide additional coverage opportunities for former school employees.  Act 110 (1988) requires school employers in Pennsylvania to give retirees and their dependents the right to continue coverage in the group health plan to which they belonged as employees.  The coverage may continue until they are eligible for Medicare benefits (usually age 65) or until they are covered by another group health insurance plan.  Act 43 (1989) amended Act 110 by defining those retirees eligible for continuation of group coverage as those who:

• took superannuation retirement on or after age 62,
• retired with thirty (30) years of service, OR
• were receiving PSERS disability benefits

Many Pennsylvanian school district employers provide to their retirees continuing insurance coverage benefits that meet or exceed the provisions of COBRA and Acts 110/43.  Collective bargaining agreements often provide more liberal and comprehensive insurance opportunities than those mandated by these laws.

Most, but not all, Pennsylvania school retirees find it advantageous to continue in their former employer plans until they become eligible for Medicare.  Most employer sponsored plans discontinue coverage when you begin to receive Medicare benefits unless you happen to still be employed.  See Retiree Medicare Options for coverage at age 65.