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Summary of Material Modification

This notification serves as a Summary of Material Modification (“SMM”) to the Duke University Welfare and Fringe Benefits Plan. This SMM modifies and supplements the benefits described in the official Summary Plan Description (SPD) for these plans. If you have any questions about the benefits addressed in this document, contact the Human Resource Information Center at (919) 684-5600 or email hr@duke.edu.

1. Extension of COBRA Notice and Election Windows, Premium Payment, and Claims Filing and Appeals Deadlines applicable to all Duke Health Plans effective January 1, 2021

  • COBRA Notice and Election Window – For participants with a qualifying life event occurring on or after March 1, 2020, the qualifying event notice deadline (e.g., the deadline by which an employee must notify Duke of the loss of other coverage, acquisition of a new spouse or dependent, loss of eligibility for Medicaid or CHIP coverage, or gain of eligibility for state premium assistance subsidy under Medicare or CHIP) is extended to 60 days following the end of the COVID national emergency, as determined by the federal government. The election window for COBRA coverage of Medical, Dental, Vision, or Health Care Reimbursement Accounts is extended to 60 days following the end of the COVID national emergency, as determined by the federal government. The extension of the election window does not extend the length of time that an individual is eligible to continue COBRA coverage.
  • COBRA Premium Payment – For participants who have elected COBRA coverage on or after March 1, 2020, the initial premium payment deadline is extended to 60 days following the end of the COVID national emergency, as determined by the federal government. The deadline for subsequent premium payments is also extended to 60 days following the end of the COVID national emergency, as determined by the federal government. The extension of the premium payment deadline does not prohibit the cancellation of COBRA coverage if payment is not received timely, but allows for the reinstatement of coverage once premium payments are received.
  • COBRA Claims Filing and Appeals Deadline – For participants who have elected COBRA coverage on or after March 1, 2020, the ERISA claims and appeals submission deadlines (e.g., the deadlines by which a claim for benefits or an appeal of a denied claim for benefits under Duke’s Medical, Dental, Vision, or Health Care Reimbursement Account plans) are extended to 60 days following the end of the COVID national emergency, as determined by the federal government.

2. Clarification of Infertility Services provided under the Aetna Duke Select and BCBS Duke Options Plans effective January 1, 2022

  • Infertility Services – Member Copayments, Coinsurance, and Deductible amounts incurred for Infertility Services do not accrue towards the Plans’ Out-of-Pocket Maximums.

If this summary has been delivered to you by electronic means, you have the right to receive a written Summary of Material Modification and may request a copy at no charge by contacting the Plan Administrator. Except as set forth above, all other provisions of the Plan remain unchanged.

Benefits