Loss of Eligibility- COBRA

Federal Law requires that employers sponsoring group health plans offer their employees and their families the opportunity for a temporary extension of health coverage (called "continuation coverage") at group rates, in certain instances, where coverage under the plan would otherwise end.

  • Employees and/or their dependents who lose benefit eligibility may elect to temporarily continue medical, dental and/or vision insurance through COBRA (Consolidated Omnibus Budget Reconciliation Act).
  • Under the provisions of COBRA, the member pays the full premium cost plus a 2% administrative fee.
  • Once established, the employee and/or dependent pays the premiums directly to the carrier. 

If you are the spouse/domestic partner of an employee covered by the health, dental and/or vision plans, you have the right to choose continuation coverage for yourself if you lose group coverage under the health, dental, and/or vision plans for any of the following reasons:

  • Death of your spouse/domestic partner
  • Separation of your spouse's/domestic partner’s employment (for reasons other than gross misconduct) or reduction in a spouse's hours of employment
  • Divorce, domestic partnership dissolution or legal separation from your spouse/domestic partner 

If you are the dependent child of an employee covered by the health, dental and/or vision plans, you have the right to choose continuation coverage for yourself if you lose group coverage under the health, dental, and/or vision plans for any of the following reasons:

  • Death of parent
  • Termination or reduction in a parent's hours of employment
  • Parent's divorce, domestic partnership dissolution or legal separation
  • You become permanently disabled and unable to self-support

 
Note: Under the law, the employee and/or dependents have the responsibility to inform the HR Benefits Department of a divorce, legal separation, child losing dependent status, or Social Security Disability determination within sixty (60) days of the event or the date on which coverage would be lost under the health, dental and/or vision plans, whichever is later.