Sergeants Benevolent Association of the NYPD
SERGEANTS BENEVOLENT ASSOCIATION
COBRA BENEFIT INFORMATION
Qualifying Events
A qualifying event is one that, in the absence of COBRA, would otherwise terminate you and/or your dependent(s)’ Active Fund (City of New York Health Benefits and SBA Health & Welfare).
Qualifying events include:
- Termination of your employment, other than for gross misconduct;
- Reduction of work hours;
- Your death;
- Your entitlement to Medicare;
- Divorce or legal separation;
- Termination of domestic partnership;
- With respect to your dependent child, his/her ceasing to satisfy the Fund’s definition of an eligible dependent.
Notifying the Fund of a Qualifying Event
It is your responsibility (or that of your dependent) to notify the Fund administrator of the occurrence of any qualifying event. You must notify the Fund administrator, of the termination of your employment or reduction of work hours that result in a loss of coverage.
Election Period
You and/or your dependent(s) may elect to continue coverage within 60 days or later of:
- The date you and/or your dependent(s) would otherwise lose coverage due to a qualifying event, or,
- The date you and/or your dependent(s) are notified of your right to elect the continuation coverage. To elect COBRA continuation of health coverage, the COBRA-eligible person must complete a “COBRA – Continuation of Coverage Application” form provided by the City of New York. To indicate your interest in electing any Active Fund (SBA) benefits, you must answer “Yes” to the question “Do you wish to purchase benefits from your welfare fund?” which appears on the COBRA application form.
For additional information on the City COBRA benefits, write to or call:
- City of New York Health Benefits Program
-
40 Rector Street, 3rd Floor
New York, NY 10006 - (212) 513-0470
- (212) 306-7300
- (212) 306-7600
We suggest you also write or call the Active Fund indicating your desire to participate in the COBRA continuation of health benefits program.
Support
For additional information on SBA COBRA coverage please contact the SBA Health & Welfare Fund at (212) 431-6555.