26 Making the Election for COBRA Continuation Coverage When the Fund Office receives information concerning the loss of health care coverage due to a qualifying event, the participant or eligible family member will be sent a notice explaining their right to elect COBRA Continuation Coverage. The notice provides you (or eligible family member) with information regarding your coverage options and the cost to you associated with each option. The Notice also will include an election form you must complete and return to the Fund Office within the applicable time in order to activate your coverage under COBRA. The completed election form must be submitted to the Fund Office, within 60 days after the later of; (1) the date coverage would otherwise end, or (2) the date the qualified beneficiary receives the notice of the right to elect Continuation Coverage. Each qualified beneficiary who elects Continuation Coverage must be named on the election form, or a separate election form must be submitted for any person not named on the form. If, for any reason, the Fund Office does not receive a completed election form within the 60-day period for any particular qualified beneficiary, the eligibility period for that qualified beneficiary to elect COBRA Continuation Coverage will expire and his or her health benefits will terminate as of the date on which he or she first became a qualified beneficiary (i.e., when coverage under the Plan terminated). Neither the Fund Office nor the Plan will be responsible if a parent or guardian, acting on behalf of a minor qualified beneficiary, does not inform the minor qualified beneficiary of his or her right to elect COBRA Continuation Coverage within the 60-day period. Cost of COBRA Continuation Coverage The cost of coverage under COBRA is paid totally by you or the other qualified beneficiary covered under the Plan. The monthly rates you will self-pay reflect the cost of medical benefits under the Plan, plus a 2% administration fee as allowed under COBRA. In the event that your coverage is based on a Social Security Administration or Railroad Retirement Board disability award, your monthly premium may include a surcharge. Also, the rate for COBRA coverage may change due to changes in the benefits offered by the Plan and, in certain circumstances, to reflect changes in the cost of the Plan’s benefits. Absent these restrictions or conditions, your COBRA rate generally will remain in effect for a period of 12-months. Under the law, you are required to pay the full cost for this coverage. More details are included in the individual COBRA election notice you will receive. The initial payment must be received by the Plan within 45 days after the date of your election for COBRA Continuation Coverage. The initial premium must be paid to cover the period of coverage from the date of the election, retroactive to the date of the loss of coverage due to the Qualifying Event. Subsequent premiums amounts will be due on the first day of each calendar month for the duration of the applicable period of coverage. It is the responsibility of each qualified beneficiary or person acting on behalf of a qualified beneficiary, to ensure that the Fund Office receives the correct payment on a timely basis. Neither the Plan or the Fund Office is responsible if the qualified beneficiary causes himself or herself to lose Continuation Coverage through a failure to submit the correct payment in a timely fashion.