COBRA Participant FAQs

By law, you have sixty (60) days to elect to continue coverage under COBRA. The sixty day period starts with the later of the postmark date on the letter from our COBRA vendor in which you were notified of your right to continue coverage or the date that you lost coverage due to a qualifying event. Failure to make your election in that timeframe will result in a loss of your ability to continue benefits under COBRA.

You would elect by completing the Group Benefits Continuation Plan Enrollment Form that was included in your COBRA notice. Simply fill out the form as directed, sign and date the form and return to the COBRA vendor. If you wish to reinstate your benefits immediately, you should include a check for the first month’s premium with your Enrollment form (your elections will not become effective until the COBRA vendor receives your payment, if full, for the first month’s premium).

You have 45 days from the date you elect to continue coverage to pay premiums for the coverage’s that you are electing to continue. Please note, however, that when you elect to continue coverage under COBRA, your coverage goes all of the way back to the first day following the date upon which you lost coverage due to a qualifying event. The amount of the payment that will be due no later than 45 days following the date that you elect to continue coverage must be for all months of coverage from the start of your continuation coverage through the current month. EXAMPLE: You lose coverage on January 1 and make your election to continue on February 28. You then make your first payment on April 10. Your first payment must include the premium amount due for four months (January, February, March, and April).

Each dependent that was covered under the plan the day before the qualifying event has an individual right to elect or reject COBRA coverage, even if the Primary Qualified Beneficiary does not elect coverage. For example; if John Doe is the employee and the day before the qualifying event John had his wife Jane and daughter Susan covered, either Jane or Susan may elect COBRA even if John does not elect the coverage.

You may elect to continue any one or more of the benefits you are being offered. You do not have to continue them all.

For every month after you make your first premium payment, the law requires that you must make your payment on the first day of the month for which the premium applies. However, the law also provides for a “grace period” of 30 days after that date. That means that you must make your payment and send it no later than 30 days after the date that the premium was due in order to continue your coverage. Premium payments postmarked after that date will be rejected and returned to you, and your coverage will be terminated as of the last day of the month for which you had made a timely payment for coverage.

Your COBRA /State Continuation coverage is scheduled to begin on your “date of lost coverage,” which is either 1) the day after you were no longer on the active employee coverage or 2) at the end of the month in which you were no longer eligible for active employee coverage, depending on your particular plan(s). Please refer to your initial COBRA/State Continuation notice for the specific beginning date for your continuation coverage. Federal/State guidelines do not allow a break in coverage and require that your coverage begin the day after your date of lost coverage even if you have not incurred any claims during that time.

Each carrier is different. When you elect to continue coverage and make your first premium payment, some carriers will issue new ID cards, but most often your social security number is “turned back on” in the carrier’s system, which indicates to them that you have coverage and that you can continue to use the cards that were issued to you when you were on active employee coverage under the plan(s). If your particular carrier(s) issues new cards, you should be receiving them in the mail shortly after the COBRA vendor has processed your signed enrollment form and initial payment and has notified the carrier(s) that you wish to continue on COBRA/State Continuation.

No. Your coverage is terminated as of your date of lost coverage and will only be continued after that date when you elect COBRA and make your first premium payment. Once the COBRA vendor receives your election and your first payment, we notify the carrier(s) and have your coverage reinstated.

This timeline varies from one carrier to another. The COBRA vendor communicates enrollment eligibility to the carrier(s) twice a week, and termination eligibility once weekly. However, the length of time that each carrier takes to actually make these changes and update their systems could be anywhere from a couple of days to as many as 30 days. If you elect COBRA, and while you are waiting for the carrier to reinstate your coverage you incur expenses that should be covered by the plan, please contact the carrier directly for instructions on how you can receive reimbursement for the expenses that should have been covered.

A Qualifying Event is when any one of a set of specified events occurs while a Group Health Plan is subject to COBRA and that causes a Covered Employee (or spouse or dependent child of a Covered Employee) to lose coverage under the Group Health Plan. The specified events are (1) termination of employment (except for reasons of “gross misconduct”) or reduction in hours of employment; (2) death; (3) divorce or legal separation; (4) entitlement to Medicare; (5) a dependent child’s loss of dependent status; and (6) loss of coverage due to an employer’s filing for bankruptcy protection. COBRA allows for the continuation of the Group Health Plan coverage for affected Qualified Beneficiaries for a certain number of months (see the Glossary for “18-Month Event,” “29-Month Event,” and “36-Month Event).

A Qualified Beneficiary is any individual who, on the day before a Qualifying Event, is covered under a Group Health Plan either as a Covered Employee, the spouse of a Covered Employee, or the dependent child of a Covered Employee; or any child born to or placed for adoption with a Covered Employee during a period of COBRA continuation coverage.

A Covered Employee can be a Qualified Beneficiary only in connection with two of the six Qualifying Events - - these are a Qualifying Event that results from his/her termination of employment (except for reasons of “gross misconduct”) or reduction of hours, or from the employer’s bankruptcy. On the other hand, Qualified Beneficiaries who are not Covered Employees (i.e., the Covered Employee’s spouse or dependent children) can elect to continue coverage under the Group Health Plan if they lose coverage for any of the six types of Qualifying Events.