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COBRA

COBRA - What is it?

COBRA is federal legislation that provides employees and their families an opportunity to continue health coverage due to a qualified event resulting in a loss of health insurance. It allows employees and/or eligible dependents to purchase (on an after-tax basis) an extension of their university medical, dental, and health care flexible spending account benefits. Employees are also eligible for the benefits of the university's employee assistance program, Impact Solutions. Domestic partners are not eligible to continue benefits under COBRA.


How COBRA Works

Employees and/or their dependents are eligible for continuation of coverage under COBRA if they are enrolled in the medical, dental, or health care flexible spending account and experience a qualifying event.

After a qualifying person is enrolled in COBRA, that person can change his/her benefit elections just as they could while enrolled as an active employee. For example, changes can be made during annual enrollment or within 31 days of a qualified status change. No one who applies for COBRA will be asked to furnish evidence of insurability.

Timing of COBRA Election

Medical and dental coverage ends on the last day of the month in which the separation of employment is effective. Qualifying persons must pay for any expenses they incur between the time their university coverage ends and when they pay their first COBRA premium. However, COBRA will retroactively cover any eligible out-of-pocket medical expenses once the first premium payment is made (if made within the required timeframe), provided the expenses incurred are covered by the applicable medical or dental plan.

Cost

Qualifying persons pay the entire cost of medical or dental coverage, plus a 2% administration fee.

Disabled individuals may be able to continue coverage for as long as 29 months (18 months following separation of employment plus an additional 11 months).  In this case, the cost will be higher for the additional 11-months of coverage.  The cost during the 11 month period is 150% of the plan's cost at the time of the qualifying event for each person who extends coverage.

COBRA Administration

United Healthcare (UHC) is the university’s COBRA administrator.  Following separation of employment or other qualifying event resulting in loss of coverage, qualifying persons will receive a COBRA information packet including a COBRA Participant Guide from UHC.

Contact Information for COBRA Customer Service:

Website: http://www.uhcservices.com
Email: cobra_kyoperations@uhc.com

Phone: 866-747-0048
Fax:      866-525-1740

Business Hours: 8 a.m. to 8 p.m. (Eastern Time)

Payment Due Dates

After the initial COBRA election and payment, payment is due the first of each month with a grace period of 30 days.

COBRA coverage will not be activated until the first premium payment is received by United Health Care.

Payments with billing coupons are to be sent to:

United Healthcare
Attn: Benefit Services
P.O. Box 713082
Cincinnati, OH 45271-3082

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Electing COBRA Coverage

To elect coverage continuation under COBRA, a qualifying person must complete an election form and return it to the UHC.  Each qualified person has a separate right to elect continuation

Qualifying persons have 60 days to elect an extension of benefits.  This 60-day period begins on the later of these two dates:

  • the date benefits end for the employee or dependent, or
  • the date the employee or dependent is notified of his/her right to elect extended coverage.

The university Human Resources Department must be notified within 60 days if there is a qualifying event.  If election for COBRA is not made within the 60-day period, eligibility for extended coverage under COBRA ends.  COBRA coverage begins, retroactive to the first day of eligibility when the first payment is received, if received within the required timeframe.

When COBRA Coverage Ends

Under certain circumstances, coverage under COBRA may be terminated during the extension period.  COBRA coverage can be terminated if:

  • the required premium payments are not paid in full on time,
  • the qualifying person becomes covered as an employee under another group health plan*,
  • a qualifying dependent becomes covered under another group plan*,
  • the qualifying person or the employee's dependents become enrolled in Medicare benefits (COBRA coverage ends only for the person who is enrolled in Medicare)

COBRA coverage can continue for the remainder of the COBRA coverage period if the other group health plan has a pre-existing condition exclusion that limits coverage.  In this situation, COBRA coverage can continue only for the qualifying person, or the employee's dependent to whom the pre-existing condition exclusion applies.

Qualifying Events

In the event that: Coverage may continue for: For as
long as:
An employee's employment is terminated for any reason (except gross misconduct) The employee and his/her eligible* dependents 18 months**
An employee's hours are reduced and the employee loses benefits The employee and his/her eligible* dependents 18 months**
An employee dies The employee's eligible dependents 36 months
An employee gets a divorce or legal separation from his/her spouse The spouse and the employee's eligible** dependents 36 months
An employee's child is no longer eligible for benefits That eligible dependent 36 months
An employee becomes enrolled in Medicare benefits The employee's eligible* dependents 36 months

Exclusions and Limitations

* Dependents are eligible for COBRA coverage if they were covered under the plan(s) the day before the qualifying event occurred.  For COBRA purposes, newborn and adopted children are qualified beneficiaries with immediate enrollment rights.

** If an employee or his/her dependents are disabled (as determined under the Social Security Act) within 60 days of a qualifying event, the employee and his/her dependents can extend coverage for an additional 11 months (total 29 months).  However, the disabled person must notify the Human Resources Department and the appropriate insurance companies of the disability within the initial 18-month extension period and within 60 days after he/she receives notification that the disability is recognized by the Social Security Administration.  Additionally, if an employee dies, becomes divorced or legally separated from his/her spouse, or eligible for Medicare during the initial 18-month period, his/her dependents can extend coverage for an additional 18 months based on the second qualifying event, provided the Human Resources Department is notified within 60 days of the second qualifying event.

It is the employee's responsibility to notify the university Human Resources department within 60 days if he/she has a qualifying event.

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