Federal law requires that most group health plans (including this plan) give employees and their families the opportunity to continue their benefit coverage (dental, vision and prescription through the Health and Welfare Fund and basic health care through the School District Benefits office) when there is a ‘qualifying event’ that would result in the loss of coverage under the employer’s plan. The School District of Philadelphia (SDP) has engaged Discovery Benefits to do the billing for Personal Choice or Keystone COBRA effective May 1, 2017. You will send your payments to the new company starting with your payment for May 2017. This is for medical coverage only. Nothing has changed with the PFT Health and Welfare Fund.
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To reach Discovery Benefits:
Toll Free: (866) 451-3399 option 1, 2
Hours of Operations:
Monday – Friday
7:00 AM to 10:00 PM EST
In addition, under Commonwealth law, Act 110/43 requires school districts to extend health care coverage until Medicare eligibility in the plan to which the retiree belonged as an active employee, to eligible retirees and their dependents. Call the Fund for more information.
Length of COBRA Coverage Period:
- In the case of a loss of coverage due to the end of employment or reduction in hours of employment, coverage generally may be continued for up to a total of 18 months.
- In the case of a loss of coverage due to an employee’s death, divorce or legal separation, the employee’s becoming eligible for Medicare or a dependent child ceasing to be a dependent under the terms of the Plan, coverage may be continued for up to a total of 36 months. It is the member’s responsibility to notify the Fund office within 60 days of death, divorce or a dependent child ceasing to be a dependent under the terms of the Plan.
Social Security Disability Determination:
- If it is determined that you or any other qualified beneficiary in your family (e.g., your spouse or dependent child(ren), if any) was determined to be disabled (by the Social Security Administration) at any time during the first 60 days of COBRA coverage or before COBRA coverage began and the individual is still disabled at the end of the original maximum continuation period (generally 18 months), the original maximum continuation period may be extended for up to an additional 11 months for all qualified beneficiaries who elected COBRA coverage on account of the initial qualifying event. This extension applies only if the Fund is notified in writing before the end of the initial maximum COBRA period and within 60 days of the later of (1) the date the qualified beneficiary is notified of the disability determination by the Social Security Administration; (2) the date you terminated or reduced your hours of employment; and (3) the date on which coverage would be lost under the plan as a result of your termination or reduction in hours of employment.
Early Termination of COBRA Coverage:
- COBRA coverage may terminate early if the required premium payment is not paid when due or if the Fund were to terminate for all active participants.