COBRA continuation coverage
for chevron health plans

• COBRA coverage is only available for these health plans: medical, dental, mental health and substance use disorder, vision plus, health care flexible spending account (HCSA), Health Decision Support and Healthy You (formerly called Healthy Heart).
• You can elect COBRA coverage for the plans in which you’re enrolled at the time of your termination of employment. So, if you’re not enrolled in Chevron plan(s) at the time of your termination, you cannot elect COBRA coverage.
• You can enroll your eligible dependents that are enrolled as your dependents in active employee coverage at the time of your termination of employment. In addition, your dependents can only elect continuation coverage for the plans in which they are enrolled at the time of your termination of employment. So, if your dependents are not enrolled in Chevron plan(s), you cannot elect COBRA coverage for those dependents.
• COBRA coverage is available for a limited time. COBRA coverage is typically available for up to 18 months. In some cases, due to disability or subsequent qualifying events, coverage may be available up to 29 or 36 months.
• All terminated eligible employees will be offered the opportunity to enroll in COBRA, even if you’re eligible for Chevron retiree medical coverage. 

• 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.

• 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 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.

• 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. 

• 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 you are a pre-65 employee and decide to enroll in Chevron retiree health benefits due to the Loss of Chevron COBRA coverage enrollment milestone, be advised that you are only permitted 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).
• You and your eligible dependents cannot simultaneously participate in both COBRA and Chevron retiree health benefits. You cannot mix and match - choose COBRA coverage for certain benefits, but retiree health coverage for others. 
• There is no ability to split retiree and dependent coverage. In other words, you cannot be enrolled in COBRA coverage while your dependent is enrolled in Chevron retiree health benefits, or vice versa.
• If you or your dependent is eligible for pre-65 Chevron retiree health coverage, and you plan to participate in COBRA coverage, 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. 
• Participants who are post-65 at the time of COBRA enrollment, are permitted to continue COBRA coverage for the full eligibility period (typically 18 months) as long as you timely pay your premiums.  
• You do not need to be enrolled in Medicare Part A and Part B coverage to participate in COBRA. However, if you (or your eligible dependent) are eligible for Medicare, 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. This means that if you are not enrolled in Medicare Part A and Part B, you will not receive the maximum level of reimbursement under Medicare and your Chevron medical plan for any services while enrolled in COBRA. 
• The costs for Chevron retiree health coverage and COBRA continuation coverage will differ. Keep in mind the company contributes to retiree health coverage, if you’re eligible, but generally doesn’t contribute to COBRA continuation coverage (unless you're eligible for subsidized COBRA).

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.

• Because you are post-65 at the time you terminate employment, you're permitted to continue COBRA coverage for your full eligibility period (typically 18 months) as long as you timely pay your premiums. The same rule applies if your eligible dependent is also currently post-65. 
• You do not need to be enrolled in Medicare Part A and Part B coverage to participate in COBRA. However, if you (or your eligible dependent) are eligible for Medicare, 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. This means that if you are not enrolled in Medicare Part A and Part B, you will not receive the maximum level of reimbursement under Medicare and your Chevron medical plan for any services while enrolled in COBRA. 
• You and your eligible dependents cannot simultaneously participate in both COBRA and Chevron retiree health benefits. You cannot mix and match - choose COBRA coverage for certain benefits, but retiree health coverage for others. You also cannot enroll in COBRA coverage, and simultaneously participate in the Post-65 Retiree HRA Plan for the company contribution.
• There is no ability to split retiree and dependent coverage. In other words, you cannot be enrolled in COBRA coverage while your dependent is enrolled in Chevron retiree health benefits, or vice versa.
• If your dependent is eligible for pre-65 Chevron retiree health coverage, and you plan to participate in COBRA coverage, you must make an election with the HR Service Center or on the BenefitConnect website to cancel/decline your dependent's pre-65 retiree coverage within 31 days of when your employment ends. 
• COBRA coverage may affect future post-65 health coverage choices. If you choose to participate in COBRA continuation coverage prior to starting Chevron retiree health benefits, there can be a significant impact to your post-65 individual medical and prescription drug plan choices through Via Benefits due to guarantee issue rules. Contact Via Benefits at 1-844-266-1392 to discuss this guarantee issue situation further prior to making a COBRA enrollment decision.
• The costs for Chevron retiree health coverage and COBRA continuation coverage will differ. Keep in mind the company contributes to retiree health coverage, if you’re eligible, but generally doesn’t contribute to COBRA continuation coverage (unless you're eligible for subsidized COBRA).

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 this 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.