- Qualifying Events
- When And How You Must Give Notice
- Length of COBRA Coverage
- Electing Coverage
- COBRA Premium Payments
- COBRA Rates
- Trade Adjustment Assistance(TAA)
- Termination Of COBRA Coverage
- Questions, Notices and Address Change
The right to COBRA coverage was created by the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). COBRA coverage may become available to you and your family members when you would otherwise lose your health care coverage.
This is a general explanation of COBRA coverage, when it may become available to you and your family, and what you must do to protect your rights to receive it.
“Qualifying Events” are certain events that cause an individual to lose health care coverage. Qualifying Events that trigger your right to COBRA coverage are:
- Voluntary or involuntary termination of the covered employee’s employment for reasons other than “gross misconduct”;
- Reduced hours of work for the covered employee, resulting in ineligibility for health coverage;
- Divorce or legal separation of the covered employee;
- Death of the covered employee;
- Loss of status as an “eligible dependent child” under plan rules;
- The covered employee becomes entitled to Medicare, resulting in ineligibility for coverage; or
- The employer files a Chapter 11 bankruptcy (only applicable to retired employees and their dependents covered under a retiree medical program).
The Qualifying Event you experience determines your notice requirements and the amount of time you may retain COBRA coverage.
When And How You Must Give Notice
You, your spouse, or dependent child must notify the University Benefits Department of a divorce or legal separation, or a child losing dependent status within 60 days of the event. (The Plan is required to provide notice to you and/or your enrolled dependents of the right to elect COBRA coverage due to any of the other Qualifying Events.)
To provide this notice, you may complete the Health Care Coverage Change Form. Alternatively, your spouse or dependent child may give written notice of the Qualifying Event to the Benefits Department. The written notice must provide the individual’s name and current mailing address, the specific Qualifying Event and the date of the Qualifying Event.
If written notice is not provided to the Benefits Department within 60 days after the date of the Qualifying Event, all rights of that individual to elect COBRA coverage will be lost.
If you are enrolled in COBRA coverage and experience a Second Qualifying Event or are determined by the Social Security Administration to be disabled, you must also notify the Benefits Department.
Length of COBRA Coverage
The length of COBRA coverage offered depends on your Qualifying Event.
- If the Qualifying Event is termination of employment or a reduction of work hours, Qualified Beneficiaries are given the opportunity to continue COBRA coverage for 18 months.
- If a Qualified Beneficiary is determined to have been disabled on the date of the Qualifying Event or during the first 60 days of COBRA coverage, additional coverage may be available; however COBRA coverage will never be extended beyond 36 months of the date of the original Qualifying Event.
- If the Qualifying Event is death of the covered employee, divorce or legal separation, or loss of dependent status, COBRA coverage is available for 36 months.
Qualified Beneficiaries have 60 days from the date of the Qualifying Event or if later, from the date of the University’s notice offering COBRA, to elect COBRA coverage. (You are not eligible to elect COBRA coverage if you, your spouse, or dependent child failed to notify the University’s Benefits Department of a divorce, legal separation or a child losing dependent status within 60 days of the event.)
If neither you nor your spouse or dependent child(ren) elect COBRA continuation coverage during the applicable election period, your health care coverage will end according to the terms of the Plan.
COBRA Premium Payments
If you elect COBRA coverage, you will be responsible to pay the full cost of coverage plus a 2% administration fee. The COBRA premiums, including this fee, will be listed on your “Notice of Right to Elect Continuation Coverage (COBRA).” Coupons will be provided for premium payments; however, in the event you do not receive coupons, you are responsible for making payments timely to avoid termination of coverage.
- Payment must be received by the University Benefits Department within 45 days of the date you elect COBRA coverage. Your first premium payment will include premiums due retroactive to the date you lost coverage as a result of your Qualifying Event. If your first payment is not received timely, COBRA coverage will not be effective and you will lose all rights to COBRA coverage.
- Payment for each subsequent period is due on the first day of each month. You will have a 30-day grace period from the premium due date to make subsequent payments. If the COBRA premiums are not paid within the grace period, your COBRA coverage will terminate as of the end of the last period for which payment was received and you will lose all further rights to continue COBRA coverage.
JULY 1, 2016 THROUGH JUNE 30, 2017
|Medical Only||Medical and Dental|
|PVC - Advantage||$572.24||$1,001.42||$1,510.70||$602.88||$1,071.78||$1,621.68|
|PVC - Comprehensive||$572.24||$1,001.42||$1,510.70||$602.88||$1,071.78||$1,621.68|
|PVC - Consumer Directed Health Plan||$519.20||$908.60||$1,370.68||$549.84||$978.96||$1,481.65|
|PAR - Advantage||$602.49||$1,054.33||$1,587.92||$633.13||$1,124.69||$1,698.89|
|PAR - Comprehensive||$602.49||$1,054.33||$1,587.92||$633.13||$1,124.69||$1,698.89|
Trade Adjustment Assistance (TAA)
If you are a TAA-eligible individual and do not elect continuation coverage during the 60-day COBRA election period that was a direct consequence of the TAA-related loss of coverage, you may elect continuation coverage during a second 60-day election period that begins on the first day of the month in which you are determined to be eligible.
Termination Of COBRA Coverage
Your COBRA coverage under the Plan will end for you and/or your enrolled dependents if any of the following occurs:
- The required premium payments are not paid within the timeframe allowed;
- You notify the COBRA administrator that you wish to cancel your coverage;
- The applicable period of COBRA coverage ends;
- You become entitled to Medicare benefits;
- The date you reach the Lifetime Maximum Benefit under the Plan;
- The University terminates its group health plan(s);
- You have extended COBRA coverage due to Social Security disability and a final determination is made that you are no longer disabled, coverage for all who had qualified for the disability extension will end as of the later of:
- the last day of 18 months of continuation coverage, or
- the first day of the month that is more than 30 days following the date of the final determination of the nondisability;
- After the date of your COBRA election, you become covered under another group health plan that does not contain any exclusion or limitation for any of your pre-existing conditions (if you become covered by another group health plan with a pre-existing condition limitation that affects you, your COBRA coverage can continue); or
- An event occurs that permits termination of coverage under the University Health Care Plan for an individual covered other than pursuant to COBRA (e.g., submitting fraudulent claims).
Questions, Notices and Address Change
This web page does not fully describe COBRA coverage. For additional information about your rights and obligations under the Plan and under federal law, you should review the Plan’s Summary Plan Description or contact the Benefits Department.
The University’s COBRA Administrator is Sandy Robison, 420 Wakara Way, Suite 105, Salt Lake City, UT 84108, telephone (801) 581-7447 (the contact person may change from time to time).
If you divorce or legally separate or lose eligibility as a dependent child under the University Health Care Plan, you must provide the required written notice to the Benefits Department within 60 days.
In order to protect your Family’s rights, you should keep the Benefits Department informed of any change in address for you, your spouse, or enrolled dependent children.