COBRA continuation coveragefor chevron health plans

• You must make an election to continue coverage for you and any eligible dependents. Enrollment is not automatic. You have 60 days from the date your COBRA package is postmarked or your termination of employment date (whichever is later) to elect coverage.
• Your enrollment will be retroactive to the date your active employee coverage ended, if you elect COBRA coverage within the 60-day deadline.

The cost for COBRA coverage is 102 percent of the total group cost. The total group cost includes both of the following:

• The employee contribution. (In other words, what a similarly situated active employee pays.)
• What Chevron contributes to your coverage, also called the company contribution.

Wellness Credit

If you are receiving reduced medical premiums because you have qualified for the Wellness Credit under Health Rewards, your Wellness Credit ends when you terminate employment and the premium reduction no longer applies to your medical premium, even if you elect COBRA coverage. You can see the per pay period dollar amount of your premium reduction on the BenefitConnect website. Click on the View my coverage tile on the home page for a listing of your current coverage costs, including the Wellness Credit.

How can I estimate my cost for coverage?

There are two ways to estimate the full cost for COBRA coverage prior to leaving Chevron:

• Access your My Total Rewards website and go to the Health & Protection tab. Your statement shows a column for your cost (employee contribution) and Chevron's cost (company contribution) to your current health plan(s) at your current coverage level. Add both columns together, add the 2 percent fee and divide by 12 to get a monthly cost estimate for the full cost of COBRA coverage for each of your health plans.
• Call BenefitConnect COBRA (contact information at the bottom of this page). A representative can provide a monthly cost estimate for you for the plan(s) and coverage level(s) you desire.

Receive enrollment package

When your employment ends, your active employee coverage is terminated until you submit your COBRA elections and payment. All terminated, eligible employees will receive a COBRA package within 44 days of leaving Chevron, even if you’re eligible for Chevron retiree medical coverage. The package includes a personalized enrollment worksheet, your costs for coverage, and detailed information about enrollment procedures and payment requirements.

Enroll for coverage, if desired

Your enrollment package provides personalized instructions for enrollment. In general, to elect COBRA continuation coverage, you’ll call or go to the BenefitConnect | COBRA website. Under federal law, you have 60 days after the date of this notice to decide whether you want to elect COBRA continuation coverage. To minimize the lapse in coverage between active employee coverage and COBRA coverage, make your elections and payment as soon as possible. If you do not enroll by your enrollment deadline, you will lose your right to elect COBRA continuation coverage. If you reject COBRA continuation coverage before the enrollment deadline date, you may change your mind as long as you contact BenefitConnect | COBRA before the 60-day enrollment deadline date.

Cancel your pre-65 retiree coverage

If you or your dependent is eligible for pre-65 Chevron retiree health coverage, and you plan to participate in COBRA coverage when you leave Chevron, you must make an election with the HR Service Center or on the BenefitConnect website to cancel/decline your pre-65 retiree coverage within 31 days of when your employment ends. In addition, you cannot be enrolled in both COBRA and Chevron retiree health benefits at the same time.

Submit first payment

Once you’ve made your enrollment choices, your first invoice will be sent to you in the mail. Your COBRA enrollment elections are not complete and your coverage will not be reinstated until your first payment is received in full. Your first payment must be received no later than 45 days after the date of your election. You can inquire about the amount due for your first payment on the BenefitConnect | COBRA website or by contacting BenefitConnect | COBRA (contact information at the bottom of this page). Remember, if you don’t make your first payment in full within 45 days after the date of your election, you’ll lose all COBRA continuation coverage rights with respect to that qualifying event. You’re responsible for making sure that the amount of your first payment is correct.

Health care expenses prior to coverage reinstatement

If you incur any eligible health care expenses before the plan carrier(s) have been notified of your reinstated coverage, you can submit a claim directly to your health plan administrator for reimbursement. This means you may have to pay out of your own pocket at the time of service and submit a claim to be reimbursed later.

Periodic payments for ongoing coverage

After you make your first payment for COBRA continuation coverage, you’ll have to make periodic payments for each coverage period that follows. The enrollment package you receive will explain the process for making payments and the applicable due dates for ongoing payments, including how to enroll in AutoPay.

• If, during the COBRA coverage period, a COBRA participant turns age 65 and/or becomes eligible for Medicare, COBRA coverage will end, as per U.S. Department of Labor rules. 
• If a participant is already age 65 at the time of COBRA enrollment, the participant is permitted to enroll in COBRA coverage for the full eligibility period.

If you or a dependent will turn age 65 and/or become eligible for Medicare during your COBRA coverage period, be sure to review the applicable Special Situation(s) below on this page to understand how this might affect eligibility for Chevron retiree health benefits (if eligible).

If you (or your eligible dependent) are eligible for Medicare and are also enrolled in COBRA coverage, Medicare will be the primary payer of your medical claims*. Your Chevron medical COBRA coverage will be secondary. As the secondary payer, your Chevron medical plan will subtract the amount that Medicare Part A and Part B should pay toward your services before paying your medical claims. Your claims are paid in this manner even if you choose to not enroll in Medicare while you're enrolled in COBRA coverage. 

* Your Chevron medical COBRA coverage pays primary in the event you have Medicare due to End-Stage Renal Disease (ESRD). 

If you die while enrolled in Chevron COBRA coverage, your dependents are eligible to enroll in Chevron survivor coverage if:

• They are also enrolled in Chevron COBRA coverage as your dependent as of the date of your death.
• They report your death to the HR Service Center within 60 days of the date of your death.

Retiree enrollment milestone reminder

As a pre-65 employee who is eligible for retiree health benefits, don't forget that Loss of Chevron COBRA coverage is an enrollment milestone. Furthermore, as a pre-65 employee, this milestone limits your ability to enroll at either the end of your subsidized COBRA period (if applicable) or at the end of your full COBRA eligibility period (typically 18 months). 

Therefore, if you intend to enroll in Chevron retiree health benefits at the end of your subsidized COBRA period, it's your responsibility to initiate enrollment at the appropriate time as per the enrollment milestone. You will not receive a reminder when your subsidy period ends, and you will not receive an enrollment milestone reminder from Chevron. Please review the Loss of Chevron COBRA coverage enrollment milestone discussed on Leaving Chevron for further details.

If a COBRA participant turns age 65 during their COBRA coverage period, COBRA will end, as per U.S. Department of Labor rules. If you will turn age 65 at some point during the COBRA eligibility period (typically 18 months), plan ahead to ensure you and your dependent(s) continue to have health coverage when you turn age 65. 

Turning age 65 and becoming eligible for Medicare is an enrollment milestone for you, the retiree. This means you will be permitted to enroll yourself and your dependents in Chevron retiree health benefits at this time.

• As a reminder, Chevron post-65 retiree health benefits require enrollment in Medicare Part A and Part B to enroll, so you'll need to plan ahead at least four months in advance of turning age 65 to start Medicare enrollment. Learn more about post-65 retiree health benefits, the enrollment milestones and enrollment instructions on Leaving Chevron.
• There is no ability to split retiree and dependent coverage. In other words, your dependent cannot be enrolled in COBRA coverage while you are enrolled in Chevron retiree health benefits. This means you'll need to enroll your dependent in pre-65 or post-65 coverage, as applicable, when you initiate your retiree coverage due to the Turning Age 65 enrollment milestone.

If a COBRA participant turns age 65 during their COBRA coverage period, COBRA will end, as per U.S. Department of Labor rules. If you intend to enroll a pre-65 dependent who will turn age 65 at some point during the COBRA eligibility period (typically 18 months), plan ahead to ensure your dependent continues to have health coverage at age 65. 

• Turning age 65 and becoming eligible for Medicare is not an enrollment milestone for your dependent. This means your dependent cannot start participation in Chevron retiree health benefits only because they turned age 65 while on COBRA coverage.
• As a pre-65 employee who is eligible for retiree health benefits, the Loss of Chevron COBRA coverage enrollment milestone limits your ability to enroll in Chevron retiree health coverage to either the end of your subsidized COBRA period (if applicable) or at the end of your full COBRA eligibility period (typically 18 months). This means it's possible that you will not be able to enroll yourself and your dependent in Chevron retiree health coverage at the time your dependent's COBRA coverage ends and your dependent may therefore experience a gap in coverage.
• The Loss of Chevron COBRA coverage enrollment milestone only allows you to cover dependents who are currently enrolled in Chevron COBRA coverage. If your dependent experiences a gap in coverage due to losing COBRA coverage at age 65, you must wait until the next applicable enrollment milestone, if any, to enroll your dependent in Chevron retiree health coverage.
• There is no ability to split retiree and dependent coverage. In other words, you cannot be enrolled in COBRA coverage while your dependents is enrolled in Chevron retiree health benefits.

As a reminder, participants who are already post-65 when electing COBRA coverage are eligible to maintain COBRA coverage for the entire eligibility period, if desired.

Retiree enrollment milestone reminder

As a post-65 employee who is eligible for retiree health benefits, don't forget that Loss of Chevron COBRA coverage is an enrollment milestone. If you intend to enroll in Chevron retiree health benefits at the end of your subsidized COBRA period, it's your responsibility to initiate enrollment at the appropriate time as per the enrollment milestone. You will not receive a reminder when your subsidy period ends, and you will not receive an enrollment milestone reminder from Chevron. Please review the Loss of Chevron COBRA coverage enrollment milestone discussed on Leaving Chevron for further details.

If a COBRA participant turns age 65 during their COBRA coverage period, COBRA will end, as per U.S. Department of Labor rules. If you intend to enroll a pre-65 dependent who will turn age 65 at some point during the COBRA eligibility period (typically 18 months), plan ahead to ensure your dependent continues to have health coverage at age 65. If you want your dependent to be enrolled in Chevron retiree health coverage, you must elect Chevron post-65 retiree health coverage for yourself and your eligible dependent(s) prior to your dependent turning age 65. That's because:

• The Loss of Chevron COBRA coverage enrollment milestone only allows you to cover dependents who are currently enrolled in Chevron COBRA coverage. If your dependent has lost COBRA coverage due to turning age 65, you will not be able to enroll your dependent in Chevron post-65 retiree health benefits at the Loss of Chevron COBRA coverage milestone. 
• Your dependent's participation in Chevron retiree health coverage is tied to your participation in Chevron post-65 retiree health coverage. You cannot enroll your dependent in Chevron retiree coverage while you remain enrolled in COBRA coverage.

As a reminder, you and any eligible dependents who are already post-65 when electing COBRA coverage are eligible to maintain COBRA coverage for your entire eligibility period, if desired.

If you're eligible for subsidized COBRA, you can see the per pay period cost of your current employee coverage on the BenefitConnect website. 

• Click on the View my coverage tile on the home page for a listing of your current coverage costs. 
• Remember, your Wellness Credit (if applicable) ends when your employment ends - even with subsidized COBRA.
• With subsidized COBRA, you don't pay the monthly 2% administrative fee for COBRA coverage. 

You can also call BenefitConnect COBRA (contact information at the bottom of this page) and a representative can provide a monthly cost estimate for you for the plan(s) and coverage level(s) you desire.

If you're eligible for subsidized COBRA, your COBRA enrollment worksheet and your COBRA invoices accurately reflect your current premium payment amount at the subsidized rate. 

• Your enrollment package will also indicate the date your subsidized rate expires. 
• Your invoices will automatically reflect the new monthly premium rate when your subsidized COBRA coverage period has expired; you will not receive a reminder when the subsidy period ends. 

If you die while enrolled in Chevron subsidized COBRA coverage, your dependents are eligible to enroll in Chevron survivor coverage if:

• They are also enrolled in Chevron subsidized COBRA coverage as your dependent as of the date of your death.
• They report your death to the HR Service Center within 60 days of the date of your death.

If enrolled in subsidized COBRA on the date of your death, your survivors will be able to finish the full subsidized COBRA coverage period, however they must elect Chevron survivor coverage at the end of their subsidy period to remain eligible for Chevron survivor coverage. If your survivors choose to continue COBRA coverage beyond the subsidy period, they will forfeit all future eligibility for Chevron survivor coverage.