CONTINUATION OF COVERAGE

If your Group coverage ends for any reason other than those described under "Termination of Specific Members" above, you may continue your Kaiser Permanente coverage in one of the following ways:

Continuation of Coverage Under Federal Law (COBRA). If your Group has 20 or more employees, and if you would otherwise lose coverage, you may continue uninterrupted group coverage upon arrangement with your Group in compliance with federal law (COBRA) and upon payment of applicable monthly charges to Group, if:

1. Your coverage is through a subscriber who dies, divorces or legally separates or becomes entitled to Medicare benefits; or

2. You are a dependent child who loses eligibility; or

3. You are a subscriber (or your coverage is through a subscriber) whose employment terminates (other than for gross misconduct) or whose hours of employment are reduced.

Coverage under COBRA terminates on the earlier of:

• Termination of the Group contract, or
• Your coverage under any other group health plan that does not contain any exclusion or limitation with respect to any pre-existing condition; or entitlement to Medicare.
• Expiration of 36 calendar months after an event described in numbers 1 or 2, above.
• Expiration of 18 calendar months after an event described in number 3, above, unless the following is applied.
• Expiration of 29 months after an event described in number 3 above if you are determined by the Social Security Administration to have been disabled at the time of the event described in number 3.

To continue group coverage under COBRA, you must request continuation on a form furnished by and returned to your Group (along with payment of applicable monthly charges) usually within 60 days after your group coverage would otherwise terminate. Kaiser Permanente may terminate any member enrolled under continuation coverage for whom Kaiser Permanente does not receive payment when due. At end of continuation of coverage, you may convert to individual coverage as described below.

Continuation of Coverage Under State Law. If you are not eligible to continue uninterrupted group coverage under federal law (COBRA), you may be eligible to continue coverage under Colorado law. This law states that upon payment of the applicable monthly charges to your Group, a subscriber whose active employment involuntarily terminates may elect to continue coverage for his or her family unit if:

1. Your eligibility to receive coverage has ended for any reason other than cancellation of the group contract; and

2. The contribution required on your behalf has been paid to the termination date; and

3. You are not eligible for coverage by Medicare; and

4. You have been a member for at least six consecutive months immediately prior to termination of employment.

To continue coverage, you must request continuation of group coverage on a form furnished by and returned to your Group along with payment of applicable charges, no later than 30 days after the date on which your group coverage would otherwise terminate.

Continuation of coverage under this provision continues upon payment of applicable charges to your Group and terminates on the earlier of:

• 18 months after your coverage would have otherwise terminated because of termination of employment.
• The date you become eligible for coverage by Medicare.
• The date you become eligible for other group medical coverage.
• The date Kaiser Permanente terminates its contract with the Group.

Conversion to Individual (Non-Group) Coverage. If you, or your dependents, lose group coverage, you may continue Health Plan membership by converting to non-group membership on a direct pay basis without medical review. You must apply for non-group membership within 30 days after you lose group coverage. Non-group coverage begins at the time group coverage ends. There is no lapse between your group coverage and your non-group coverage. Covered services and Supplemental Charges under non-group membership may differ from those provided under your group plan.

If you do not convert to non-group membership within 30 days, all coverage ceases at the time group coverage ends and you must pay Non-Member Rates for any services you receive after that date. If you later decide to rejoin Kaiser Permanente on an individual basis, a medical review of your application will be necessary. You will not be allowed to convert to individual coverage if you meet the eligibility requirements for group coverage.

Continuation of Child's Coverage. There are several ways in which your child may continue Kaiser Permanente coverage.

• If eligible as disabled and dependent as described on page 3.
• If eligible as a full-time student and your child meets the criteria. Check with your Group for the limiting age for children who are dependent students.
• By arrangement with your Group in compliance with state or federal law as described above.
• By converting to individual (non-group) coverage.

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NAVIGATION

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Introduction | Benefit Changes | How to Use | Definitions | How Your Plan Works | Who Is Eligible | When Coverage Starts | Benefits And Services | Referrals and Restrictions on Choice of Providers | Emergency Services | Urgent Care | Health Plan's Appeals Procedure | Special Claims Procedures for Medicare Members | General Provisions | Binding Arbitration | Coordination Of currentbenefits | Medicare | What Is Not Covered | When Coverage Stops | Continuation Of Coverage | Customer Satisfaction Procedure | Service Information | Statement Of Financial Condition | Important Phone Numbers | Local Designated Hospitals | Supplemental Benefits | Benefit Chart

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Website for Kaiser of Colorado

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Denver Public Schools
Employee Benefits Department
900 Grant Street, Room 502
Denver, Colorado 80203
(303) 764-3371