Termination of employment for any reason other than gross misconduct. Reduction in hours of employment. Death of covered employee. Divorce or legal separation of covered employee. Covered employee becomes entitled to Medicare benefits.
Dependent child ceases to be a dependent under definition of employer's plan.
No Coverage Elected 2. List all persons, including yourself , below for whom continued coverages is desired. Your first payment must be received within 45 days of the date you sign this election form. If continuation is due to your termination of employment or reduction in hours of employment, the maximum continuation is 18 months. Otherwise, the maximum continuation is 36 months.