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07-28-09 Item 10dHow much does continuation coverage cost? Generally, each qualified beneficiary may be required to pay 102 percent of the cost of group health coverage. For Healthcare FSAs, the cost for continuation of coverage is a monthly amount calculated and based on the amount you were paying via pre -tax salary reductions before the qualifying event. When and how must payment for continuation of coverage be made? First payment for continuation coverage If you elect continuation of coverage, you do not have to send any payment for continuation coverage with the COBRA Election Form. However, you must make your first payment for continuation coverage within 45 days after the date of your election. (This is the date the Election Notice is post - marked, if mailed.) If you do not make your first payment for continuation coverage within that 45 days, you will lose all continuation coverage rights under the Plan. Your first payment must cover the cost of continuation coverage from the time your coverage under the Plan would have otherwise terminated up to the time you make the first payment. You are responsible for making sure that the amount of your first payment is enough to cover this entire period. You may contact FBMC to confirm the correct amount of your first payment (for FSAs). Your health plan will notify you of the exact premium payable. Instructions for sending your first payment for continuation coverage will be shown on your COBRA Election Notice/Form. Periodic Payments for Continuation Coverage: After you make your first payment for continuation coverage, you will be required to pay for continuation coverage for each subsequent month of coverage. Under the Plan, these periodic payments for continuation coverage are due on the first day of each month. If you make a periodic payment on or before its due date, your coverage under the Plan will continue for that coverage period without any break. MEDICAL 2009 COBRA Monthly Rates 2 0,09 Flgxible Benefits Plan http: / /en.et.miamidad Instructions for sending your periodic payments for continuation coverage will be shown on your COBRA Election Notice/Form. Grace Periods for Periodic Payments: Although periodic payments are due on the dates shown above, you will be given a grace period of 30 days to make each periodic payment. Your continuation coverage will be provided for each coverage period as long as payment for that coverage period is made before the end of the grace period for that payment. If you pay a periodic payment later than its due date but during its grace period, your coverage under the Plan will be suspended as of the due date and then retroactively reinstated (going back to the due date) when the periodic payment is made. This means that any claim you submit for benefits while your coverage is suspended may be denied and may have to be resubmitted once your coverage is reinstated. If you fail to make a periodic payment before the end of the grace period for that payment, you will lose all rights to continuation coverage under the Plan. For More Information This COBRA Q &A section does not fully describe continuation coverage or other rights under the Plan. More information about continuation coverage and your rights under the Plan is available in your summary plan description or certificate of coverage. You can get a copy of your summary plan description or certificate of coverage from FBMC (for FSAs) or your health plan. Keep Your Address Updated In order to protect your family's rights and to receive useful benefits information, you must keep your Departmental Personnel Representative informed of any change in your address. You should also keep a copy, for your records, of any notices you send to FBMC or your health plan. Optix Vision Single U55:: 2 Persons 1 amity $16:73. DENTAL 2009 COBRA Monthly Rates Met Life Standard Enriched Single . $33::50 $4185 2 .Persons., $66,26 $8610 Family $106.79 $139.78 Dental American Single $8.t30 . $11.56 2 Persons. $14.54. $19.1 "6 Family $22.25 t $.3.0.45 Oral Health Services 5rngle ` . $8.80. $11$6:: 2 Persons $14:54. $1.9.15 family. , $22:25 $30.45: 47_ 2009 Flexible .Benefits Plant; httpll /enet.miamidade.gov . 11 S 11 I 9VOITIVArel • \ ■ I 11 O i cu 7a 2 E Cu o ER-COAD n ':one iE c°„o���: f=:-E o p UL U U O .- t _L1 a) ' CD O _ 0 (V'.'.::3 ' 3: ca a d -o y N T T O 0. Ca :U. CU c m .. fa m = d CL O C6 m o L �: C6 p E 3 :N 7 - Y'. E. �n m v>o —s > fl.cv. v: ca O Eb m�L'� c a v n w o 0 CD �j it{ o o :C. .. . 2 C � t3 'p O O 5C6. 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