Non-core benefits are vision and dental services, except where they are mandated by law in which case they become core benefits. Beneficiaries may change coverage during periods of open enrollment by the plan. back to top Duration of Coverage C OBRA establishes required periods of coverage for continuation health benefits. Certain qualifying events, or a second qualifying event during the initial period of coverage, may permit a beneficiary to receive a maximum of 36 months of coverage. A beneficiary is entitled to Medicare benefits S pecial rules for disabled individuals may extend the maximum periods of coverage. If a qualified beneficiary is determined under Title II or XVI of the Social Security Act to have been disabled at the time of a termination of employment or reduction in hours of employment, and the qualified beneficiary properly notifies the plan administrator of the disability determination, the 18-month period is expanded to 29 months.
Some plans allow beneficiaries to convert group health coverage to an individual policy.
In this case, you must be given the option to enroll in a conversion health plan. The premium is generally not at a group rate. It cannot exceed 102 percent of the cost to the plan for similarly situated individuals who have not incurred a qualifying event. Premiums reflect the total cost of group health coverage, including both the portion paid by employees and any portion paid by the employer before the qualifying event, plus two percent for administrative costs. For disabled beneficiaries, the premium may be increased after 18 months to 150 percent of the plan's total cost of coverage for the last 11 months of continuation coverage.