FAQs for Post Employment Coverage

Frequently Asked Questions

Who are Discovery Benefits?

Discovery Benefits is a company contracted by the School District to handle the distribution of COBRA enrollment materials, process your enrollment and handle payment processing and monitor your eligibility. You can elect the same Keystone or Personal Choice coverage you had through Independence Blue Cross while you were an eligible employee. Retirees cannot continue medical, prescription and vision benefits with Discovery once Medicare eligible.

How do I know when my coverage ends?

Your initial enrollment materials will list the number of months coverage for which you are eligible. Each year you will receive coupons through the following June or the end of your eligibility, whichever is sooner. Discovery Benefits will mail you a notice several months before your coverage ends. You should plan in advance so you are able to enroll in coverage with no break.

Who do I contact with a question?

Contact Discovery Benefits at 866-451-3399 or cobraadmin@discoverybenefits.com regarding your enrollment, premium payment, changes to your enrolled dependents, or information on how long your coverage extends. Continue to call the number on the back of your membership ID card (1-800-ASK-Blue) for information about participating providers, pre-certification, specific benefits, and claims issues.

When are my payments due?

Payments are due on the first day of each month and must be postmarked no later than the last day of the month for which they are due. Keep in mind that your first payment may be for a period of more than one month. It will cover the entire time since your last day of coverage. Enclosed in your enrollment materials is a Premium Computation Form that lists the amount due based on the date your initial enrollment is received by Discovery Benefits Administrators. It is your responsibility to pay for coverage even if you do not receive a monthly statement.

What is considered a late payment?

Payments are due on the first day of each month. Payment received after that time are late.If you do not send the full amount listed on the Premium Computation Form with your initial enrollment, your subsequent payments will all be late.

How can I get benefits and services during the interim between the end of my active coverage and the reinstatement of my COBRA coverage?

If you need services, like a Doctor’s visit, you may have to pay for the visit and then submit it for reimbursement. The doctor’s office may be willing to hold or resubmit the bill when your coverage is reactivated.

If I elect COBRA, am I obligated to pay for the full COBRA period?

No. You may drop COBRA coverage at the end of any month. You may also drop part of your coverage (i.e., dental, prescription and Vision) or dependents at any time. However, you may not add coverage or dependents except at Open Enrollment or in case of a family status change.

If I waive COBRA coverage during the election period, can I still get coverage at a later date?

You may only elect COBRA coverage within the 60 day election period. If you or a qualified beneficiary waives COBRA coverage during the initial 60 day election period, he or she may revoke the waiver of coverage before the end of the election period. A beneficiary may then elect COBRA coverage. If you are a qualified retiree, refer to our PA Acts 110/43 section.

What is a Qualifying Event?

Qualifying events are certain events that would cause an individual to lose health coverage. The type of qualifying event will determine who the qualified beneficiaries are and the amount of time that a plan must offer the health coverage to them under COBRA.

Qualifying Events for Employees:

  • Voluntary or involuntary termination of employment for reasons other than gross misconduct
  • Reduction in the number of hours of employment

Qualifying Events for Spouses:

  • Voluntary or involuntary termination of the covered employee’s employment for any reason other than gross misconduct
  • Reduction in the hours worked by the covered employee
  • Covered employee’s becoming entitled to Medicare
  • Divorce or legal separation of the covered employee
  • Death of the covered employee

Qualifying Events for Dependent Children:

  • Loss of dependent child status under the plan rules
  • Voluntary or involuntary termination of the covered employee’s employment for any reason other than gross misconduct
  • Reduction in the hours worked by the covered employee
  • Covered employee’s becoming entitled to Medicare
  • Divorce or legal separation of the covered employee
  • Death of the covered employee

I am 10-month teacher and not planning to return for the new school year. When does my medical coverage end?

You must submit your notice of resignation or retirement by March 15 that you are not returning for the new school year. If you submit notice by March 15, your medical coverage will ended August 31.

I am over 65 and retiring. Can I keep my medical coverage through the District on a self-pay basis?

No. All District Medical Plans are  subject to a Medicare Exclusion policy. This applies to members for whom Medicare  would be the primary payer but they have not elected to enroll. Effective 7/1/2014, these members are responsible for paying their doctor, hospital, or other medical professional the amount Medicare would have paid and any applicable co-payments, co-insurance, and deductibles. In turn, the medical benefit plan will only pay the remaining balance on claims submitted as if the member had enrolled in Medicare Parts A and B. Medicare eligible retirees can elect Medicare coordinating health plans through the Health Options Program, https://www.hopbenefits.com/, or 1-800-773-7725. HOP has put together a Decision Guide to assist members.