When Coverage Ends

Requesting Additional Certificates of Creditable Coverage

In addition to the certificates you may receive automatically, you also may request a certificate within 24 months after coverage ends. The MPTN Plan will issue a certificate if a former plan participant or someone authorized by that participant submits a written request for a certificate within 24 months of the end of the MPTN coverage.

Also in response to a written request, the plan will provide a copy of this Plan Document and Summary Plan Description (SPD) and other information as outlined in the model form established by HIPAA to provide additional information on categories of benefits, for plans that use the Alternative Method of counting creditable coverage. The MPTN Plan will charge the person or organization requesting these materials a fee to cover the reasonable cost for providing such information.

MPTN COBRA health care coverage ends on the earliest of the following:

• When you or your family member becomes covered under another group health plan that does not contain an exclusion or limitation regarding any pre-existing condition you or your family member may have. (Previous coverage that you had under another group health plan, such as through your spouse’s employer, will not terminate or affect your right to elect MPTN COBRA health coverage.)
• When you or your family member becomes entitled to Medicare (usually at age 65):
  • MPTN COBRA health care coverage (excluding dental coverage) ends only for the person who becomes eligible for Medicare; individuals who are not eligible for Medicare may continue their MPTN COBRA health care coverage.
  • Dental coverage may be continued through MPTN COBRA after you become eligible for Medicare.
• When you do not make payments when required.
• When the MPTN health plan is terminated or amended to eliminate coverage and MPTN does not provide a substitute plan to team members.
• When the MPTN COBRA continuation period — 18, 29 or 36 months — ends.
• For after-tax health care FSA contributions, at the end of the plan year in which those after-tax contributions began.

Conversion

If your MPTN medical coverage (including coverage continued through MPTN COBRA) ends for any reason, you may be able to change your group coverage to a different plan, depending on the MPTN Plan in which you participate. The MPTN Human Resources office will notify you if you are eligible to convert your medical coverage and will inform you of the procedures and deadlines that apply for conversion.

If you do convert your coverage, be aware that the coverage provisions will differ from what you had as a team member.

Please note that conversion is not available for dental and vision coverage, nor for the Health Care FSA.