Your Continuation Coverage Rights Under COBRA Introduction “The igh to COBRA continuation coverage was created by fedora law, the Consolidated Omaibus Budget Fecoretaton Act o 1085 (COBRA). COBRA cortiruaton coverage can Bocome avalebis to You and oe memes of you any when group heath coverage would ctarwse end. Ths noe landed tom "You. na summary etn, of you rsa oulgatone uncer te cortuaion coverage provlons of aw, “You shoul ake tote o rude otic. “You may havo other options avaliable to you when you lose group health coverage. For exe, you maybe ge uy en vival plan trough the Hoa Insurance Maral By evaling im coverage “rough te Marketacs you may qua or wer cots on your monly pure ah ower auto pocet ‘Sons Aaonaly you Me cual for @30-2y spect ervelment porad for anther cup haath plan ft ‘Shoh yuav og urh ses apeur’s an), sem at plan get doe not acopt iat els ‘About COBRA Continuation Coverage COBRA coninuston overage lea contusion of Plan coverage when It woud athrwise and because of Ie event This ao ead a "qualtyng over” Spee qualfyng everts arctan nth hotoe Ae 8 uafing ever, COBRA contnuation coverage mutt be ofeted to cach petson who ls 8 "ualled brainy You, ‘pur spouts, ad you depandont chro could become quid benaires # coverage Uaar the Pla i lst beemuao of he quan oven. Under te Plan, quad beneianee wh ect ‘COBRA contusion coverage must pay or COBRA corruaton coverage you are an empleo of Occidental Petcleum Corporation or an afte (Oxy and ae cover by the Oxy Modal Care Plan (Par), you fave tonight chose bs contusion coverage you lose your geup Raa overage becaute ofa roaucien In your hour ef employment cr te tamination of Your employment (et ‘reasons other ban cose misondot ony pa you ar the spouse of an employee covered bythe Pian you besome aqui bata yaulase your ‘Coverage une he Man Bernas of thaalowing galing events (0) Tee ceathotyourspouse 2) A tamination of your spouse's employment (or reasons oer than gross misconduct) oF ‘redaon in your bouts hours of enetoyent wih Oxy, (9) Dene oreal separation rm your pause oF (3) Youspouse becomes ene o Medicare banlts (Part A Past Br bth, ‘Yur sependent chron wil become quaties benefiares Hf they loge coverage under the Plan because of ‘he fotoningqulyg eves (1) The ceathof he paron-omplye (2) Ateminaton of he prenkemglayee's employment (or reasons oer than goss miscondict), ‘rreducton your spouse's Rauf empoyman wh Oxy: (3) Theparentampoyede vere ortega! eoparaton (6) The parentempoyee becomes oniled to Mecca bonatts (Pa A, Part er bot) o (5) Theependent cid ceass be "dependent hid under he Pan When a QuaityingEvent Occurs ‘Unter tho law, the ompoyes oa tardy member has the reponalalty 9 inform Oxy of dre, lagal “Separan 8 ehidioung dependent statis andr ne Plan wenn 60 aaye fhe date of fhe evant or he dete invaion Soverage would ond under he Plan vecause of tha event cher else Ony hae he ‘espana to nay tee OnLine Employee Sones Cento he employers death, eminan, reson ‘outst emoymey or Medea enaomen."Simr ngs may app to conan Totes, spouses, nd ‘ependent chlten Oxy commences a barloupcy proceeding and these vival ove coverage.Wen Onin i nto’ tat ona of thse events has happened, Qx)Lnk wil In tun not each guatied ‘eneticay of hi ight choses contuaton coverage. Undo fa a, You Reve at East 60 days om the ate you would foua covrape bocause of ono oft evors dacerbad stove, or te data note of Your ‘Secton ighs is Seto yeu, wtihova ala ilnm Oryink tat you wart coninanon coverage. Ifyou donot coats contruaton coverage ona tnaly bai, you goup hea nswance wl end Ifyou choose connuaton coverage, Oxy i equted to pve you coverage wtih. a lhe time coverage it being provided Is oenea te tho Cverej provided under the Panto seal ial employees or tary tomers. The new law rogues tat you be aforded the opporunty to maltaineoruaton coverage fot {ve years ess You Tot group healh coverage becals os arminaton of ereloynani oa educon in aura” In that case required canton coverage pods 18 mon. This Temas may be exerted te 36 mah or events (ouch as sth, vores, legal spartan, or Mears enim) eau ng That iemonh pened ln. vont wl conten coverage last beyond 36 moths rm the date of the ovat that orginal made a {ulfed beneficiary wigs fo elect coverage. Tho T8 months may bo scended to 29 monte 2 ual oraisry i datanrines by the SoSal Secutty Aamnisaon to be eabed for Saaal Set Seaty Puposes) any tne asin te st 60 day of COBRA coverage. This tmnt extonion ewe Fraksals who Ste quite brats de to a minaion or redicton imu of enplymert To bene {fom ths extension. a guafedteneay must nly Aeina ofthat Geterinaton within 60 days and bore {fo ond ofthe engnal e-mont polod. The atest nda must ls nally Aetna wn 30 dys ty ‘al doarminason te he edu! en lange bl, ‘cid who ls bam too paced fr ecopton withthe covered emlayee dung & peat of COBRA coverag tito ligt to become a. qualfied banter In secordanoe wih tee teme of Be Pin and Te ‘oguromerts of fedora! law ese ques bengidaree can be added to COBRA coverage upon prope rotteatonte Aetna of he ith or dopton Other Coverage Options Instoad of aeing t COBRA corteuaon coverage, there may be ber coverage otons fr you and your ‘amiy throug the Hes Insranes arkeolco, Media or cher rou hea pan sovrape opis (uch as spouse's pa) trough what calla & "spec entnant prod Some of ese cone mY ost ae than CoB corazon soverge._ You in ammo bs Hea rece rae on may your oer option at yu healcars. eu ‘Aion leformation {esters concering your Plan or your COBRA contruaton covrape sighs shoul be adessod to the ora contacts ianitiad Blow. "Fat mre nlormaton box your atts unr the Employes Retreat Income Secuy Ac (ERISA), incu COBRA, the Palen rotcon and Moran Care Ach 850 tor live afecng group Meath pans, conta! th nearest Regional of Dstt Otioe of te US. Deparment of {tors Employee Genes Ssarly Admtraon (EBSA) n you area or vst warm dl geass, (Aaaesees ‘and phono rumbars ot Reglonl ana Distt ESA Ooms are aval hough is EBSA webae) “Ta protect your fama gis, et tha Plan Adrsstor know abut any changes in be adresses of aay rember. You shel also Kea a copy, your record, fey noes you santo the Pan Admit Plan Contact Iryourhave ary qustons abou COBRA, have chenged mafia tts, or you o your spouse have changed ‘dresses soase rely OxyLnk.Hyourave any guastons or Atha, coat the COBAA Dect Bling Unt Onin Egloyes Service Caner ‘tra nil ling Aiea ‘5008 12h net Avene 481 Famogton Avenue, MES Tuts, OK 741968879. Hartora Cr ost8e-7623 ano-sanesa| e00-0.0828,