Continuation of Coverage
Applying for COBRA coverage
Disability continuation
The cost of COBRA coverage
Address changes
When COBRA coverage begins and ends
For more information
COBRA (the Consolidated Omnibus Budget Reconciliation Act) is a federal law that allows you to continue group health care coverage at your own expense for a period of time after employer-provided coverage ends. If you and/or your dependents experience one of the qualifying events below, you or your dependents can elect to continue coverage for the corresponding time. Such coverage includes medical, dental, prescription drug, vision, mental health/substance abuse coverage, and the Health Care Reimbursement Account. All coverages you continue during COBRA, including the Health Care Reimbursement Account, will be paid for on an after-tax basis.
The coverage provided under COBRA is the same as that offered to active employees, including the right to change medical plan options at annual enrollment. Additionally, any coordination of benefit provisions of the health care plans will also apply to continued coverage under COBRA. Continued coverage may be extended if another qualifying event occurs during that time. However, no one may extend coverage for more than 36 months. The 36-month period is counted from the first event.
| QUALIFYING EVENT |
WHO MAY CONTINUE |
HOW LONG |
| Your employment stops for any reason other than gross misconduct or you have a reduction in hours |
You and your dependents |
18 months |
| Divorce, legal separation, or termination of Domestic Partnership and you stop coverage for your spouse or children |
Ex-spouse, legally separated spouse, domestic partner and/or your dependent children and domestic partner children |
36 months |
| You or a family member become eligible for Social Security disabiltiy benefits within the first 60 days of losing coverage |
You and your dependents |
29 months |
| Dependent child no longer eligible |
Dependent child |
36 months |
| You become entitled to Medicare and experience a second qualifying event, or you experience a qualifying event and then become entitled to Medicare |
Dependent spouse/DP, children & DP children |
36 months |
| Your death |
Dependent spouse/DP, children & DP children |
36 months |
In most cases, you will be notified if you are eligible to continue coverage. However, you or your dependents must notify the Plan Administrator in the event of divorce, legal separation, termination of Domestic Partnership or when a dependent child is no longer eligible for coverage. You will then receive notice of eligibility for continuation of health care coverage under the plan.
You or your dependents will have 60 days to elect to continue coverage from the later of the date your coverage would end or the date your employer notifies you of your continuation rights. You will then have an additional 45 days to pay the cost of your COBRA coverage, retroactive to the date your plan coverage ended.
Voya is responsible for administering COBRA continuation coverage. This means that Voya will be your primary contact for premium and COBRA-related matters. You may contact Voya at 888-401-3539 if you have any questions or if need to request forms.
No "evidence of insurability" (proof of good health) is required to continue coverage under COBRA.
You and your dependents ("qualified beneficiaries") have the right to elect COBRA even if you have other coverage before you elect COBRA coverage (for example, if you have coverage under your spouse or domestic partner's plan at the time your coverage under your Company plans end). However, if you obtain other coverage after electing COBRA, your COBRA coverage will end, as specified in the table above.
Each qualified beneficiary has an independent right to elect continuation coverage. For example, both the employee and the employee's spouse/domestic partner may elect continuation coverage, or only one of them. Parents may elect to continue coverage on behalf of their dependent children. A qualified beneficiary may change a prior rejection of continuation coverage any time up until the 60-day notification date. If you or your dependents do not elect COBRA continuation coverage, coverage will end on the date explained under When Coverage Begins and Ends.
Your Coverage Options
At the time your active coverage ends, you may...
- Only elect COBRA coverage under those plans in which you are already enrolled, and
- Not add previously eligible but currently uncovered dependents through COBRA.
However once you elect COBRA coverage, you are entitled to participate in the plans' Open Enrollment as long as you are still eligible for and participating in COBRA coverage at that time. During Open Enrollment you may...
- Add previously uncovered (but eligible) dependents to your coverage,
- Change your plan election(s) - for example, you may switch from the CDHP Premier to the CDHP Basic, and
- Drop any coverages you no longer want.
Keep in mind that if you declined a particular coverage (either for yourself or your dependents) at the time you became eligible for COBRA coverage or you drop a particular coverage during Open Enrollment, you (or your dependents) may never reenroll in that coverage for the remainder of your COBRA coverage period.
If Your Family Situation Changes
If while covered under COBRA (as a former employee) you gain a child, either through birth or adoption, you may enroll the child and coverage will be effective immediately as long as you enroll the child within 31 calendar days of the birth or placement.
Dependents enrolled in COBRA under such circumstances may continue COBRA coverage for the maximum period allowed.
If you or a dependent is disabled before or within 60 days of when you become eligible to continue your coverage, you and your covered dependents may extend coverage for 29 months (rather than 18 months). To extend coverage, the disabled person must:
- Be entitled to receive Social Security disability benefits, and
- Notify Voya, the COBRA Administrator, within 60 days of the latest of: (1) the date of Social Security's disability determination; (2) the date of the qualifying event; (3) the date on which the qualified beneficiary loses coverage due to the qualifying event; or (4) the date on which the qualified beneficiary is informed of the obligation to provide the notice of disability.
Additionally, if Social Security determines that the disabled person is no longer disabled, he or she must notify the Plan Administrator within 31 days of the final determination.
You (or your covered dependents) must pay a premium for COBRA continuation coverage. The monthly cost is the full cost, including both employer and employee costs, plus a 2% administrative fee as permitted by law.
The premium will not exceed 102% of the rate that would apply for an active plan member with similar coverage on the date this premium was due. However, the amount charged to disabled individuals, will be increased to 150% of the current active rate for the 19th through the 29th month.
If you have a Health Care Reimbursement Account (HRA) at the time you elect COBRA coverage, the HRA will automatically continue with Anthem until the HRA balance is exhausted.
The premium rate will be determined at the beginning of the Plan Year and will apply to anyone who elects to continue coverage during that period. The premium rate will not change during the Plan Year, unless the Company revises the group health care program for all members, or continuing dependent coverage is terminated because there are no longer any eligible dependents under COBRA coverage.
You should keep Voya, the COBRA administrator, informed of any change of address for you or your family members. You should also keep a copy of any notices you send to Voya.
COBRA coverage will begin on the first of the month following the date your active coverage ends. There should be no lapse in coverage since active coverage generally ends the last day of month following the date you or your dependents are no longer eligible, except in certain cases as described under When Coverage Begins and Ends.
An individual's continued coverage will end for any of the following reasons when:
- The cost of continued coverage is not paid on or before the date it is due,
- That person becomes entitled to, and enrolls in, Medicare after electing COBRA,
- That person becomes covered under another group health care plan (unless the individual would lose coverage due to a pre-existing condition), or
- The Company terminates all like coverage for all employees.
Further information about COBRA coverage will be provided to you and/or your dependents when you or your dependents become eligible as explained previously.
If you have questions about your COBRA continuation coverage, you should contact Voya at 888-401-3539 or you may contact the nearest Regional or District Office of the U.S. Department of Labor's Employee Benefits Security Administration (EBSA). Addresses and phone numbers of Regional and District EBSA Offices are available through EBSA's website at www.dol.gov/ebsa.