Common use of Termination of Dependent Health Plan Coverage Clause in Contracts

Termination of Dependent Health Plan Coverage. 17 Written notice from the employee upon termination of marriage 18 or domestic partnership or any other change in dependent eligibility is required. 19 Employees are responsible for timely reporting of any change in the eligibility status 20 of enrolled dependent family members to the County Employee Benefits Office. 21 a. To protect COBRA rights, employees must notify 22 Employee Benefits Office of the dependent’s status change within sixty (60) days of 23 the qualifying event. Federal law shall govern COBRA eligibility for disqualified 24 dependents. 25 b. Employees whose marriage or domestic partnership ends 26 must complete, sign, and file with the Employee Benefits Office a copy of the 27 statement of Termination of Marriage/Domestic Partnership and a Benefit Change 28 form to report the event. 29 c. Employees must remove from coverage a child who has 30 become ineligible by completing a Benefit Change form and submitting the completed 31 form to the Employee Benefits Office. 1 d. Employees who fail to remove an ineligible spouse, 2 domestic partner, or child within sixty (60) days of the qualifying event and have not 3 elected to purchase COBRA coverage for the terminated dependent will be required, 4 retroactive to the coverage end date, to reimburse the County sponsored health plan 5 for claims incurred and paid while the former spouse, partner, or child remained 6 enrolled but was no longer an eligible dependent. 7 e. Dependent health plan coverage ends on the last day of 8 the calendar month in which the termination occurs, examples. 9 Terminating Event Coverage End Date Divorce End of month divorce became final Dissolution of Oregon State registered domestic partnership End of month dissolution of partnership becomes final. Dissolution of domestic partnership initiated by Affidavit or Multnomah County registry End of month that partner moved out of shared residence Childs reaches maximum dependent ages End of the month that maximum age birth date occurs

Termination of Dependent Health Plan Coverage. 17 14 Written notice from the employee upon termination of marriage 18 or 15 domestic partnership or any other change in dependent eligibility is required. 19 Employees 16 are responsible for timely reporting of any change in the eligibility status 20 of enrolled 17 dependent family members to the County Employee Benefits Office. 21 18 a. To protect COBRA rights, employees must notify 22 Employee Benefits Office of the dependent’s status change within sixty (60) days of 23 the qualifying 20 event. Federal law shall govern COBRA eligibility for disqualified 24 dependents. 25 21 b. Employees whose marriage or domestic partnership ends 26 22 must complete, sign, and file with the Employee Benefits Office a copy of the 27 statement 23 of Termination of Marriage/Domestic Partnership and a Benefit Change 28 form to report the 24 event. 29 25 c. Employees must remove from coverage a child who has 30 26 become ineligible by completing a Benefit Change form and submitting the completed 31 form 27 to the Employee Benefits Office. 1 28 d. Employees who fail to remove an ineligible spouse, 2 domestic 29 partner, or child within sixty (60) days of the qualifying event and have not 3 elected to 30 purchase COBRA coverage rights for the terminated dependent will be required, 4 retroactive to the 31 coverage end date, to reimburse the County sponsored health plan 5 for claims incurred 1 and paid while the former spouse, partner, or child remained 6 enrolled for coverage but 2 was no longer an eligible dependent. 7 3 e. Dependent Termination of dependent health plan coverage ends on the last day 4 end of 8 the calendar month in which the termination event occurs, examples. 9 Terminating Event Coverage End Date Divorce End of month divorce became final 5 Dissolution of State of Oregon State registered domestic partnership Domestic Partnership End of month dissolution of partnership becomes final. became final Dissolution of domestic partnership initiated by Affidavit or of Multnomah County registry Registry End of month that partner moved out of shared residence Childs Child reaches maximum dependent ages age End of the month that maximum age birth date occurs

Termination of Dependent Health Plan Coverage. 17 8 Written notice from the employee upon termination of marriage 18 or domestic partnership or any other change in dependent eligibility is required. 19 Employees are responsible for timely reporting of any change in the eligibility status 20 11 of enrolled dependent family members to the County Employee Benefits Office. 21 12 a. To protect COBRA rights, employees must notify 22 13 Employee Benefits Office of the dependent’s status change within sixty (60) days of 23 14 the qualifying event. Federal law shall govern COBRA eligibility for disqualified 24 15 dependents. 25 16 b. Employees whose marriage or domestic partnership ends 26 17 must complete, sign, and file with the Employee Benefits Office a copy of the 27 18 statement of Termination of Marriage/Domestic Partnership and a Benefit Change 28 19 form to report the event. 29 20 c. Employees must remove from coverage a child who has 30 21 become ineligible by completing a Benefit Change form and submitting the completed 31 22 form to the Employee Benefits Office. 1 23 d. Employees who fail to remove an ineligible spouse, 2 24 domestic partner, or child within sixty (60) days of the qualifying event and have not 3 25 elected to purchase COBRA coverage for the terminated dependent will be required, 4 26 retroactive to the coverage end date, to reimburse the County sponsored health plan 5 27 for claims incurred and paid while the former spouse, partner, or child remained 6 28 enrolled but was no longer an eligible dependent. 7 29 e. Dependent health plan coverage ends on the last day of 8 30 the calendar month in which the termination occurs, examples. 9 Terminating Event Coverage End Date 31 Divorce End of month divorce became final Dissolution of Oregon State registered domestic partnership End of month dissolution of partnership becomes final. Dissolution of domestic partnership initiated by Affidavit or Multnomah County registry End of month that partner moved out of shared residence Childs reaches maximum dependent ages End of the month that maximum age birth date occurs

Termination of Dependent Health Plan Coverage. 17 Written notice from the employee upon 23 Employees must report termination of marriage 18 or domestic 24 partnership or any other change in dependent eligibility is required. 19 Employees are responsible for timely reporting of any change in the eligibility status 20 of enrolled dependent family members dependents to 25 the County Employee Benefits Office.Office within sixty (60) days of the dependent status 21 27 a. To protect COBRA rights, employees must notify 22 the 28 Employee Benefits Office of the dependent’s status change within sixty (60) days of 23 the 29 qualifying event. Federal law shall govern COBRA eligibility for disqualified 24 dependents. 25 30 b. Employees whose marriage or domestic partnership ends 26 31 must complete, sign, and file with the Employee Benefits Office submit a copy of the 27 statement Statement of Termination of Marriage/Domestic Partnership and a Benefit Change 28 form 1 complete the benefit change process to sufficiently report the event. 29 2 c. Employees must remove from coverage a child who has 30 3 become ineligible by completing a Benefit Change form and submitting the completed 31 form to the Employee Benefits Officebenefit change process. 1 4 d. Employees who fail to remove an ineligible spouse, 2 domestic 5 partner, or child within sixty (60) days of the qualifying event and have not 3 elected to 6 purchase COBRA coverage for the terminated dependent will be required, 4 retroactive to 7 the coverage end date, to reimburse the County sponsored health plan 5 for claims incurred 8 and paid while the former spouse, partner, or child remained 6 enrolled for coverage but 9 was no longer an eligible dependent. 7 10 e. Dependent health plan coverage ends on the last day of 8 the 11 calendar month in which the termination event occurs, examples. 9 Terminating Event Coverage End Date Examples: 12 Divorce End of month divorce became final Dissolution of State of Oregon State registered domestic partnership Registered Domestic Partnership End of month dissolution of partnership becomes final. became final Dissolution of domestic partnership Domestic Partnership initiated by Affidavit or of Multnomah County registry Registry End of month that partner moved out of shared residence Childs Child reaches maximum dependent ages age End of the month that maximum age birth date occurs

Termination of Dependent Health Plan Coverage. 17 34 Written notice from the employee upon termination of marriage 18 or domestic 1 partnership or any other change in dependent eligibility is required. 19 Employees are 2 responsible for timely reporting of any change in the eligibility status 20 of enrolled dependent 3 family members to the County Employee Benefits Office. 21 4 a. To protect COBRA rights, employees must notify 22 Employee 5 Benefits Office of the dependent’s status change within sixty (60) days of 23 the qualifying 6 event. Federal law shall govern COBRA eligibility for disqualified 24 dependents. 25 7 b. Employees whose marriage or domestic partnership ends 26 must 8 complete, sign, and file with the Employee Benefits Office a copy of the 27 statement of 9 Termination of Marriage/Domestic Partnership and a Benefit Change 28 change form to report the event. 29 10 c. Employees must remove from coverage a child who has 30 11 become ineligible by completing a Benefit Change form and submitting the completed 31 form to 12 the Employee Benefits Office. 1 13 d. Employees who fail to remove an ineligible spouse, 2 domestic 14 partner, or child within sixty (60) days of the qualifying event and have not 3 elected to 15 purchase COBRA coverage for the terminated dependent will be required, 4 retroactive to the 16 coverage end date, to reimburse the County sponsored health plan 5 for claims incurred and 17 paid while the former spouse, partner, or child remained 6 enrolled for coverage but was no 18 longer an eligible dependent. 7 19 e. Dependent Termination of dependent health plan coverage ends on the 20 last day of 8 the calendar month in which the termination event occurs, examples. 9 Terminating Event Coverage End Date : 21 Divorce End of month divorce became final Dissolution of Oregon State registered domestic partnership End of month became final dissolution of partnership becomes final. Dissolution of domestic partnership initiated by Affidavit or Multnomah County registry End of month that partner moved out of shared residence Childs Child reaches dependent age maximum dependent ages End of the month that maximum age birth date occurs

Termination of Dependent Health Plan Coverage. 17 Written notice from the employee upon termination of marriage 18 or domestic partnership or any other change in dependent eligibility is required. 19 Employees are responsible for timely reporting of any change in the eligibility status 20 of enrolled dependent family members to the County Employee Benefits Office. 21 a. To protect COBRA rights, employees must notify 22 Employee Benefits Office of the dependent’s status change within sixty (60) days of 23 the qualifying event. Federal law shall govern COBRA eligibility for disqualified 24 dependents. 25 b. Employees whose marriage or domestic partnership ends 26 must complete, sign, and file with the Employee Benefits Office a copy of the 27 statement of Termination of Marriage/Domestic Partnership and a Benefit Change 28 change form to report the event. 29 c. Employees must remove from coverage a child who has 30 become ineligible by completing a Benefit Change form and submitting the completed 31 form to the Employee Benefits Office. 1 d. Employees who fail to remove an ineligible spouse, 2 domestic partner, or child within sixty (60) days of the qualifying event and have not 3 elected to purchase COBRA coverage for the terminated dependent will be required, 4 retroactive to the coverage end date, to reimburse the County sponsored health plan 5 for claims incurred and paid while the former spouse, partner, or child remained 6 enrolled for coverage but was no longer an eligible dependent. 7 e. Dependent health plan coverage ends on the last day of 8 the calendar month in which the termination event occurs, examples. 9 Terminating Event Coverage End Date Examples: Divorce End of month divorce became final Dissolution of Oregon State registered domestic partnership End of month dissolution of partnership becomes final. became final Dissolution of domestic partnership initiated by Affidavit or Multnomah County registry End of month that partner moved out of shared residence Childs reaches maximum dependent ages End of the month partner moved out of shared residence End of month that maximum age birth date occurs

Termination of Dependent Health Plan Coverage. 17 10 Written notice from the employee upon termination of marriage 18 11 or domestic partnership or any other change in dependent eligibility is required. 19 12 Employees are responsible for timely reporting of any change in the eligibility status 20 13 of enrolled dependent family members to the County Employee Benefits Office. 21 14 a. To protect COBRA rights, employees must notify 22 15 Employee Benefits Office of the dependent’s status change within sixty (60) days of 23 16 the qualifying event. Federal law shall govern COBRA eligibility for disqualified 24 17 dependents. 25 18 b. Employees whose marriage or domestic partnership ends 26 19 must complete, sign, and file with complete the Employee Benefits Office a copy of the 27 statement of Termination of Marriage/Domestic Partnership and a 20 through the Benefit Change 28 form process to report the event. 29 21 c. Employees must remove from coverage a child who has 30 22 become ineligible by completing a the Benefit Change form and submitting process . Removal of a 23 dependent that ages off the completed 31 form to plan does not require any action on the Employee Benefits Officeemployee’s part. 1 24 d. Employees who fail to remove an ineligible spouse, 2 25 domestic partner, or child within sixty (60) days of the qualifying event and have not 3 26 elected to purchase COBRA coverage for the terminated dependent will be required, 4 27 retroactive to the coverage end date, to reimburse the County sponsored health plan 5 28 for claims incurred and paid while the former spouse, partner, or child remained 6 29 enrolled but was no longer an eligible dependent. 7 30 e. Dependent health plan coverage ends on the last day of 8 31 the calendar month in which the termination occurs, examples. 9 Terminating Event Coverage End Date Divorce End of month divorce became final Dissolution of Oregon State registered domestic partnership End of month dissolution of partnership becomes final. Dissolution of domestic partnership initiated by Affidavit or Multnomah County registry Registry End of month that partner moved out of shared residence Childs reaches maximum dependent ages End of the month that maximum age birth date occurs

Termination of Dependent Health Plan Coverage. 17 31 Written notice from the employee upon termination of marriage 18 or domestic 32 partnership or any other change in dependent eligibility is required. 19 Employees are 33 responsible for timely reporting of any change in the eligibility status 20 of enrolled dependent 34 family members to the County Employee Benefits Office. 21 1 a. To protect COBRA rights, employees must notify 22 Employee Benefits Office of the dependent’s status change within sixty (60) days of 23 the qualifying 3 event. Federal law shall govern COBRA eligibility for disqualified 24 dependents. 25 4 b. Employees whose marriage or domestic partnership ends 26 must 5 complete, sign, and file with the Employee Benefits Office a copy of the 27 statement of 6 Termination of Marriage/Domestic Partnership and a Benefit Change 28 change form to report the event. 29 7 c. Employees must remove from coverage a child who has 30 8 become ineligible by completing a Benefit Change form and submitting the completed 31 form to 9 the Employee Benefits Office. 1 10 d. Employees who fail to remove an ineligible spouse, 2 domestic 11 partner, or child within sixty (60) days of the qualifying event and have not 3 elected to 12 purchase COBRA coverage for the terminated dependent will be required, 4 retroactive to the 13 coverage end date, to reimburse the County sponsored health plan 5 for claims incurred and 14 paid while the former spouse, partner, or child remained 6 enrolled for coverage but was no 15 longer an eligible dependent. 7 16 e. Dependent Termination of dependent health plan coverage ends on the 17 last day of 8 the calendar month in which the termination event occurs, examples. 9 Terminating Event Coverage End Date : 18 Divorce End of month divorce became final Dissolution of Oregon State registered domestic partnership End of month dissolution of partnership becomes final. became final Dissolution of domestic partnership initiated by Affidavit or Multnomah County registry End of month that partner moved out of shared residence Childs Child reaches maximum dependent ages age End of the month that maximum age birth date occurs

Termination of Dependent Health Plan Coverage. 17 Written notice from the employee upon termination of marriage 18 or domestic partnership or any other change in dependent eligibility is required. 19 Employees are responsible for timely reporting of any change in the eligibility status 20 of enrolled dependent family members to the County Employee Benefits Office. 21 a. To protect COBRA rights, employees must notify 22 Employee Benefits Office of the dependent’s status change within sixty (60) days of 23 the qualifying event. Federal law shall govern COBRA eligibility for disqualified 24 dependents. 25 b. Employees whose marriage or domestic partnership ends 26 must complete, sign, and file with the Employee Benefits Office a copy of the 27 statement of Termination of Marriage/Domestic Partnership and a Benefit Change 28 change form to report the event. 29 c. Employees must remove from coverage a child who has 30 become ineligible by completing a Benefit Change form and submitting the completed 31 form to the Employee Benefits Office. 1 d. Employees who fail to remove an ineligible spouse, 2 domestic partner, or child within sixty (60) days of the qualifying event and have not 3 elected to purchase COBRA coverage for the terminated dependent will be required, 4 retroactive to the coverage end date, to reimburse the County sponsored health plan 5 for claims incurred and paid while the former spouse, partner, or child remained 6 enrolled but was no longer an eligible dependent.and 7 e. Dependent Termination of dependent health plan coverage ends on the last day of 8 the calendar month in which the termination event occurs, examples. 9 : Terminating Event Coverage End Date Divorce End of month divorce became final Dissolution of Oregon State registered domestic partnership End of month dissolution of partnership becomes final. Dissolution of domestic partnership initiated by Affidavit or Multnomah County registry End of month that partner moved out of shared residence Childs reaches maximum dependent ages End of the month that maximum age birth date occursDate

Termination of Dependent Health Plan Coverage. 17 Written notice from the employee upon termination of marriage 18 or domestic partnership or any other change in dependent eligibility is required. 19 Employees are responsible for timely reporting of any change in the eligibility status 20 of enrolled dependent family members to the County Employee Benefits Office. 21 a. (1) To protect COBRA rights, employees must notify 22 Employee Benefits Office of the dependent’s status change within sixty within (602) days of 23 the qualifying event. Federal law shall govern COBRA eligibility for disqualified 24 dependents. 25 b. Employees whose marriage or domestic partnership ends 26 must complete, sign, and file with the Employee Benefits Office a copy of the 27 statement of Termination of Marriage/Domestic Partnership and a Benefit Change 28 form to report the event. 29 c. (3) Employees must remove from coverage a child who has 30 become ineligible because he or she is twenty-three (23) years old, or for any other reason by completing a Benefit benefit Change form and submitting the completed 31 form to the Employee Benefits Office. 1 d. (4) Employees who fail to remove an ineligible spouse, 2 domestic partner, or child within sixty (60) days of the qualifying event and have not 3 elected to purchase COBRA coverage rights for the terminated dependent will be required, 4 retroactive to the coverage end date, to reimburse the County County-sponsored health plan 5 for claims incurred and paid while the former spouse, partner, or child remained 6 enrolled for coverage but was no longer an eligible dependent. 7 e. Dependent (5) Termination of dependent health plan coverage ends on the last day end of 8 the calendar month in which the termination event occurs, examples. 9 : Terminating Event Coverage End Date Divorce End of month divorce became final Dissolution of Oregon State registered domestic partnership End of month dissolution of partnership becomes final. became final Dissolution of domestic partnership initiated by Affidavit or Multnomah County registry End of month that partner moved out of shared residence Childs reaches maximum dependent ages Child Marries End of the month that maximum age birth date occursmarriage occurred

Termination of Dependent Health Plan Coverage. 17 20 Written notice from the employee upon termination of marriage 18 21 or domestic partnership or any other change in dependent eligibility is required. 19 22 Employees are responsible for timely reporting of any change in the eligibility status 20 of 23 enrolled dependent family members to the County Employee Benefits Office. 21 24 a. To protect COBRA rights, employees must notify 22 25 Employee Benefits Office of the dependent’s status change within sixty (60) days of 23 the 26 qualifying event. Federal law shall govern COBRA eligibility for disqualified 24 dependents. 25 27 b. Employees whose marriage or domestic partnership 28 ends 26 must complete, sign, and file with the Employee Benefits Office a copy of the 27 29 statement of Termination of Marriage/Domestic Partnership and a Benefit Change 28 change form to 30 report the event. 29 31 c. Employees must remove from coverage a child who 32 has 30 become ineligible by completing a Benefit Change form and submitting the completed 31 33 form to the Employee Benefits Office. 1 34 d. Employees who fail to remove an ineligible spouse, 2 35 domestic partner, or child within sixty (60) days of the qualifying event and have not 3 36 elected to purchase COBRA coverage for the terminated dependent will be required, 4 37 retroactive to the coverage end date, to reimburse the County sponsored health plan 5 for 38 claims incurred and paid while the former spouse, partner, or child remained 6 enrolled for 39 coverage but was no longer an eligible dependent. 7 40 e. Dependent health plan coverage ends on the last 41 day of 8 the calendar month in which the termination event occurs. Examples: 42 ARTICLE 11, examples. 9 Terminating Event Coverage End Date HEALTH AND WELFARE 40 Divorce End of month divorce became final Dissolution of Oregon State registered domestic partnership End of month dissolution of partnership becomes final. became final Dissolution of domestic partnership initiated by Affidavit or Multnomah County registry End of month that partner moved out of shared residence Childs Child reaches maximum dependent ages age End of the month that maximum age birth date occurs

Termination of Dependent Health Plan Coverage. 17 31 Written notice from the employee upon termination of marriage 18 or domestic 32 partnership or any other change in dependent eligibility is required. 19 Employees are 33 responsible for timely reporting of any change in the eligibility status 20 of enrolled dependent 34 family members to the County Employee Benefits Office. 21 1 a. To protect COBRA rights, employees must notify 22 Employee Benefits Office of the dependent’s status change within sixty (60) days of 23 the qualifying 3 event. Federal law shall govern COBRA eligibility for disqualified 24 dependents. 25 4 b. Employees whose marriage or domestic partnership ends 26 must 5 complete, sign, and file with the Employee Benefits Office a copy of the 27 statement of 6 Termination of Marriage/Domestic Partnership and a Benefit Change 28 change form to report the event. 29 7 c. Employees must remove from coverage a child who has 30 8 become ineligible by completing a Benefit Change form and submitting the completed 31 form to 9 the Employee Benefits Office. 1 10 d. Employees who fail to remove an ineligible spouse, 2 domestic 11 partner, or child within sixty (60) days of the qualifying event and have not 3 elected to 12 purchase COBRA coverage for the terminated dependent will be required, 4 retroactive to the 13 coverage end date, to reimburse the County sponsored health plan 5 for claims incurred and 14 paid while the former spouse, partner, or child remained 6 enrolled for coverage but was no 15 longer an eligible dependent. 7 16 e. Dependent Termination of dependent health plan coverage ends on the 17 last day of 8 the calendar month in which the termination event occurs, examples. 9 Terminating Event Coverage End Date : 18 Divorce End of month divorce became final Dissolution of Oregon State registered domestic partnership End of month became final dissolution of partnership becomes final. Dissolution of domestic partnership initiated by Affidavit or Multnomah County registry End of month that partner moved out of shared residence Childs Child reaches dependent age maximum dependent ages End of the month that maximum age birth date occurs

Termination of Dependent Health Plan Coverage. 17 29 Written notice from the employee upon termination of marriage 18 or 30 domestic partnership or any other change in dependent eligibility is required. 19 1 Employees are responsible for timely reporting of any change in the eligibility status 20 of 2 enrolled dependent family members to the County Employee Benefits Office. 21 3 a. To protect COBRA rights, employees must notify 22 Employee 4 Benefits Office of the dependent’s status change within sixty (60) days of 23 the qualifying 5 event. Federal law shall govern COBRA eligibility for disqualified 24 dependents. 25 6 b. Employees whose marriage or domestic partnership ends 26 7 must complete, sign, and file with the Employee Benefits Office a copy of the 27 statement 8 of Termination of Marriage/Domestic Partnership and a Benefit Change 28 form to report 9 the event. 29 10 c. Employees must remove from coverage a child who has 30 11 become ineligible because he or she is twenty-three (23) years old, or for any other 12 reason by completing a Benefit Change form and submitting the completed 31 form to the 13 Employee Benefits Office. 1 14 d. Employees who fail to remove an ineligible spouse, 2 domestic 15 partner, or child within sixty (60) days of the qualifying event and have not 3 elected to 16 purchase COBRA coverage rights for the terminated dependent will be required, 4 retroactive to the 17 coverage end date, to reimburse the County sponsored health plan 5 for claims incurred 18 and paid while the former spouse, partner, or child remained 6 enrolled for coverage but 19 was no longer an eligible dependent. 7 20 e. Dependent Termination of dependent health plan coverage ends on the last day of 8 the calendar month in which the termination occurs, examples. 9 Terminating Event Coverage End Date Divorce End of month divorce became final Dissolution of Oregon State registered domestic partnership End of month dissolution of partnership becomes final. Dissolution of domestic partnership initiated by Affidavit or Multnomah County registry End of month that partner moved out of shared residence Childs reaches maximum dependent ages Child Marries End of the month that maximum age birth date marriage occurred 21 end of the calendar month in which the termination event occurs, examples. 22 24 L. When Benefits Coverage Begins and Ends 25 1. Coverage for new employees 26 a. Medical and Dental Benefits 9 2. Benefits coverage for terminating employees 10 a. Retirees 11 i. County-subsidized coverage 17 b. Other terminating employees