COBRA Coverage Under the Retiree Medical Plan
There are situations in which your enrolled dependents or you may lose coverage under the Retiree Medical Plan. Your eligible enrolled dependents and you may be able to elect COBRA continuation coverage under the Retiree Medical Plan in certain situations. You and your dependents right to COBRA continuation coverage under the Retiree Medical Plan is described below.
Eligibility of Dependents
Continued medical coverage, known as COBRA coverage, may be available to your dependents who are enrolled in the Retiree Medical Plan if your dependent loses Retiree Medical Plan coverage for one of the following reasons, known as a "Qualifying Event":
  • you and your spouse divorce or legally separate;
  • your dependent child no longer qualifies as an eligible dependent under the Retiree Medical Plan; or
  • you die.
If your enrolled dependent elects COBRA coverage and pays the COBRA premiums, your dependent may continue Retiree Medical Plan coverage for up to 36 months from the date on which Retiree Medical Plan coverage would otherwise end.
Each enrolled dependent who meets the definition of a qualified beneficiary is entitled to make separate elections regarding COBRA coverage.
Qualified dependents must be covered under your plan at the time of the actual qualifying event. Dependents who are taken off your coverage prior to the event will have their right to continued health care coverage through COBRA jeopardized. In the case of divorce, you may be held financially responsible for providing health coverage for dependents dropped prematurely.
Dependents who are dropped during the Open Enrollment process may not qualify for continued coverage under COBRA since these rights are only triggered by certain qualifying events and specific notification to the Company. If you drop a dependent during the Open Enrollment period and are not sure whether your dependent is eligible for COBRA due to a qualifying event, please contact the PG&E Benefits Service Center at 866-271-8144 (open weekdays from 7:30 a.m. to 5 p.m. Pacific time). COBRA rights may be jeopardized if contact with the PG&E Benefits Service Center is not made within 60 days of the qualifying event.
Eligibility of Retirees
A filing of a proceeding in bankruptcy under Title 11 of the United States Code can be a Qualifying Event. If a proceeding in bankruptcy is filed with respect to the company from which you retired, and that bankruptcy results in the loss of coverage of any retired employee within certain time periods, the retired employee and his or her covered dependents may become eligible for COBRA continuation coverage.
Domestic Partners (Retirees only)
Registered domestic partners and their children are not covered by COBRA. However, the Company extends the same type of coverage rights to registered domestic partners and their children which it would extend to qualified beneficiaries under COBRA. Qualifying events to obtain this COBRA-like coverage are the same as those for spouses and dependents under COBRA, including the dissolution of a registered domestic partnership.
Important Alternative to COBRA Coverage If You Die
If you die, your eligible covered dependents have a choice of continuing their Retiree Medical Plan coverage under COBRA or under the Survivor Medical Benefits offered by the Company to Surviving Dependents of Company employees and retirees. See "Eligible Survivors of Retirees."
When COBRA Coverage Ends
COBRA coverage will end at the expiration of the maximum COBRA period. COBRA coverage will end before the expiration of the maximum COBRA period if:
  • you or your dependents fail to pay the required premium when due (failure to meet COBRA's payment deadline — even by a day — will end your COBRA coverage and you will not be able to re-enroll);
  • you or your dependents become covered under another group health plan which does not contain a pre-existing condition limitation which would affect benefits for that individual;
  • you or your dependents become entitled to Medicare (Medicare entitlement terminates all coverage only for the individual covered by Medicare);
  • you or your dependent's coverage is terminated for cause, such as submitting false claims; or
  • the Company's group health care plans are terminated.
Note: You or your dependents must notify Ceridian Benefits Services at 800-877-7994 if you become covered under another group health plan.
Cost of COBRA Continuation Coverage
You and your dependents must pay the cost of COBRA coverage during the COBRA period, if you or your dependents elect COBRA coverage. You will pay 100% of the full premium, plus a 2% administrative charge. The Company will no longer contribute any amount toward the cost of your health care coverage.
You must pay for COBRA coverage on a monthly basis. You must make your first payment within 45 days after the date on which you elect COBRA coverage. The first payment will include the cost of coverage retroactive to the first month in which your Company-sponsored coverage would otherwise end. Subsequent premiums are due the first of each month. Premiums cannot be deducted from your pension check.
If payment is not received by the first of each month, your COBRA coverage is cancelled. You will have grace period of 30 days to pay your late premium. If you do not make your payment by the last day of the grace period, your COBRA coverage will not be reinstated. Please note that claims may not be paid until after you have made all COBRA payments that are due through the date on which the health care expense was incurred.
How to Obtain COBRA Continuation Coverage
If you get divorced or legally separated, or if your dependent child no longer qualifies as an eligible dependent under the plans, you must notify the PG&E Benefits Service Center within 60 days to request continued coverage through COBRA for your qualified beneficiaries. In the event you die, your enrolled dependents must notify the PG&E Benefits Service Center of our death within 60 days. (These events are referred to as "qualifying events".) The Company will then advise the third-party COBRA administrator to provide your enrolled dependents with information regarding COBRA coverage, if your dependents are eligible.
If your domestic partnership ends, the effective date of the qualifying event is the date on which your partnership no longer meets the criteria governing the initial registration of your relationship. You must notify the PG&E Benefits Service Center within 31 days to drop your former domestic partner and his or her children, if applicable. If you fail to notify the PG&E Benefits Service Center within 60 days of termination of your domestic partnership, continuation coverage for your former domestic partner and/or his or her children will be denied.
When any of these events occurs and you notify the Company appropriately, Ceridian CobraServ, the Company's third-party administrator, will send your dependents a COBRA enrollment package to their last known address, if they are eligible. The package will contain information about their rights under COBRA, including the required COBRA forms to elect continuation coverage. It is important to note that your dependents do not have to show that they are insurable to elect COBRA coverage.
The required COBRA forms must be completed and returned to Ceridian CobraServ within 60 days from the date on which the election forms are sent by Ceridian CobraServ. If you or your eligible dependents do not file the COBRA election forms within this 60-day period, COBRA rights will be forfeited and your group health coverage will end effective the last day of the month in which the qualifying event occurred.
If you need to report the occurrence of a qualifying event or if you have any questions about whether or not a dependent is eligible for COBRA continuation coverage, contact the PG&E Benefits Service Center at 866-271-8144 (open weekdays from 7:30 a.m. to 5 p.m. Pacific time).
To obtain complete details of the terms and conditions of continued coverage through COBRA or to request the required COBRA forms to elect COBRA coverage, contact Ceridian CobraServ at 800-877-7994.
The federal regulations that govern COBRA have established very specific timelines and enrollment requirements that must be followed in order to obtain COBRA continuation coverage. It is important that you and your covered eligible dependents read all the information that is received regarding COBRA continuation coverage.