Continuation of Benefits Information
COBRA
This notice applies to you and your eligible dependents should you elect coverage under the Mesquite ISD’s group health, dental, and/or vision insurance plan(s).
The notice outlines covered participants' potential future options and more importantly your notification obligations under the federal Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) should you ever lose your health, dental, and/or vision insurance in the future for certain reasons.
Step #1:
Please read the notice carefully. It is important that each individual covered under the plan read the notice and be familiar with the information. Should you add additional dependents in the future, notice to the covered employee and spouse at this time will be deemed notification to that newly covered dependent as well.
Step #2:
If there is a covered dependent whose legal residence is not yours, you are required to provide in writing to the benefits department the appropriate address so a separate notice can be sent to them as well. Please use the COBRA Address Notification Form located at the end of this notice for this purpose. Should you ever move in the future, please use this form to keep us informed so you can receive future information if needed.
Step #3:
Understand Your Notification Obligations! Under the terms of the group health, dental, and vision plan(s), only a spouse and eligible dependents, as defined by the insurance policy, can be covered under the plan. Therefore, under the rules of the policy and federal law, you or a covered spouse/dependent are required to notify the plan administrator of a divorce/legal separation or if a covered dependent ceases to be a dependent under the terms of the group plan. Please take special note of the section in the notice that details your notification obligations and the appropriate steps to take when making this notification. Should you fail to follow the outlined notification procedures; any available rights will be lost.
Step #4:
Place this notice in your records for future reference. Should you have any questions concerning this notice or your notification obligations, please do not hesitate to call the benefits department at 972-882-7359.
General Notice of COBRA Continuation Coverage Rights
IMPORTANT INFORMATION PLEASE READ
Click Here for Sample COBRA Specific Rights Notice
It is important that all covered individuals (employee, spouse, and dependent children, if able) take the time to read this notice carefully and be familiar with its contents. If there is a covered dependent whose legal residence is not yours, please provide written notification with the Address Notification Form to the benefits department so a notice can be sent to them as well.
Under federal law, Mesquite ISD is required to offer covered employees and covered family members the opportunity for a temporary extension of health, dental, and/or vision coverage (called "Continuation Coverage") when coverage under the health, dental, and/or vision plan would otherwise end due to certain qualifying events. This notice is intended to inform all plan participants, in a summary fashion of your potential future options and obligations under the continuation coverage provisions of the COBRA law. Should an actual qualifying event occur in the future, the plan administrator will send you additional information and the appropriate election notice at that time.
Notification Of Address Change
To ensure all covered individuals receive information properly and efficiently, it is important you notify Mesquite ISD of any address change as soon as possible. Failure on your part to do so will result in delayed notifications or a loss of continuation coverage options. Complete a Cobra Address Notification Form, sample located at the end of this notice.
Any Questions?
Remember, this notice is simply a summary of your potential future options. Should an actual qualifying event occur and it is determined that you are eligible for continuation of coverage, you will be notified of all your actual rights at that time. If any covered individual does not understand any part of this summary notice or has questions regarding the information or your obligations, please contact the Mesquite ISD Benefits Office at 972-882-7359.
COBRA ADMINISTRATION CONTACT INFORMATION
Health continuation of coverage:
If you have any questions concerning your rights to health continuation of coverage, you should contact TaxSaver Plan at csr@taxsaverplan.com or 1-888-602-6272. If you want to talk to someone about the medical insurance or the BCBS IL network, please call 855-760-3135. If you want to speak with someone about the prescription benefits or Prime Therapeutics, call 855-649-9607. To find a doctor, check claim status, manage your health and more, go to: www.myblueelementil.com.
For more information about your rights under ERISA, including COBRA, the Health Insurance Portability and Accountability Act (HIPAA), and other laws affecting group health plans, contact the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) in your area or visit the EBSA Web site at www.dol.gov/ebsa. (Addresses and phone numbers of Regional and District EBSA Offices are available through EBSA’s Web site.)
Dental continuation of coverage: If you have questions concerning your rights to dental continuation of coverage, you should contact Mesquite ISD Benefits Office at 972-882-7359 or write to Mesquite ISD Benefits Office, 3819 Towne Crossing, Mesquite, TX 75150.
Vision continuation of coverage: If you have questions concerning your rights to vision continuation of coverage, you should contact Mesquite ISD Benefits Office at 972-882-7359 or write to Mesquite ISD Benefits Office, 3819 Towne Crossing, Mesquite, TX 75150.
COBRA Qualifying Event Notification Form
COBRA Address Notification Form
