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<br />. . <br /> <br />The Covered Employee must send the Company a copy of the Social Security Administration's notice of <br />disability status: <br />(a) within 60 days after they fmd that the Covered Person is disabled, and before the I8-month <br />continuation period expires; and again <br />(b) within 30 days after they fmd that he or she is no longer disabled. <br /> <br />(3) Subsequent Qualifyin(: Event. If the Covered Employee's Dependent: <br />(a) is a QualifIed BenefIciary; and <br />(b) has a subsequent Qualifying Event during the 18- or 29-month continuation period; <br />then coverage for that Covered Dependent may be continued for up to 36 months, from the date the <br />Covered Employee's employment ended. <br /> <br />Loss of Dependent Eli&ibility. If a Covered Dependent's eligibility ends, due to a Qualifying Event other than the Covered <br />Employee's termination of employment; then that Dependent's coverage may be continued for up to 36 months, from the date of the <br />event. Such events may include: <br />(1) the Covered Employee's death, divorce, legal separation, or Medicare entitlement; and <br />(2) a child's reaching the age limit, getting married or ceasing to be a full-time student. <br />One or more subsequent Qualifying Events may occur during the Covered Dependent's 36-month period of continued coverage; but <br />coverage may not be continued beyond 36 months, from the date of the fIrst event. <br /> <br />Medicare Entitlement. If the Covered Employee's eligibility under this Policy ends when he or she becomes entitled to Medicare <br />benefIts; then coverage may not be continued for the Covered Employee, But coverage may be continued for any Covered <br />Dependents for up to 36 months, from the Covered Employee's Medicare entitlement date. <br /> <br />If the Covered Employee's eligibility under this Policy continues beyond Medicare entitlement, but later ends upon termination of <br />employment or retirement; then any Covered Dependents may continue coverage for up to: <br />(1) 36 months from the Covered Employee's Medicare entitlement date; or <br />(2) 18 months from the date the Covered Employee's employment ended (whichever is later), <br /> <br />NOTICE REQUIREMENTS. The Group Policyholder is required by law to notify the Company within 30 days after the following <br />Qualifying Events: <br />(1) the Covered Employee's termination of employment, hours reduction or retirement; and <br />(2) the Covered Employee's death or becoming entitled to Medicare benefIts, <br /> <br />The Covered Employee: <br />(1) must notify the Group Policyholder within 60 days of a divorce; a legal separation; or a child's ceasing to be an <br />eligible Dependent, as defmed by this Policy; and <br />(2) must notify the Company within 60 days of the Social Security Administration's fInding that a Covered Person <br />was disabled within 60 days after the Covered Employee's termination of employment. <br /> <br />ELECTION. To continue Dental Insurance, the Covered Person must notify the Group Policyholder of such election within 60 days <br />from the latest of: <br />(1) the date of the Qualifying Event; <br />(2) the date coverage would otherwise end due to the Qualifying Event; or <br />(3) the date the Group Policyholder sends notice of the right to continue, <br />Payment for the cost of the insurance for the period prior to the election must be made to the Group Policyholder, within 45 days after <br />the date of such election, Subsequent payments are to be made to the Group Policyholder, in the manner described by the Group <br />Policyholder. The Group Policyholder will remit all payments to the Company. <br /> <br />GL11-20-COBRA <br /> <br />29 <br /> <br />09/01/01 <br />