About COBRA
In some cases, you, your spouse (including a former spouse) and your children have the option to extend your health, dental and/or vision coverages beyond the time they would normally end by paying the full cost of coverage. The chart below describes these cases.
| COBRA Qualifying Events and Continuation Periods | ||
|---|---|---|
If... |
Then... |
|
| Your employment ends for any reason (other than gross misconduct)... or You go on leave without pay... or Your hours are reduced so that you are no longer eligible... |
Coverage for you and/or your covered family members can be extended for up to 18 months. | |
| You die... or You divorce or legally separate... |
Coverage for your covered family members can be extended for up to 36 months. | |
| Your covered child no longer qualifies for coverage... | Coverage for the child can be extended for up to 36 months. | |
| You elect extended coverage due to employment termination, leave without pay or reduction in hours and you or a covered family member qualifies for Social Security disability benefits within 60 days of the date coverage ends... | Coverage for the disabled person and all covered family members can be extended for up to 29 months. | |
You must notify your Human Resources office when you or family members experience certain events that would cause coverage to end. In other cases, you will not have to provide notification. See the chart below for notification, election and payment deadlines. Failure to meet these deadlines will cause you or your dependents to lose your right to continue health, dental and/or vision coverage.
| COBRA Timeline | ||
|---|---|---|
|
|
|
You and/or your dependents have 60 days after the event to notify Human Resources of the event. Your Human Resources office has 44 days after your notification to send you and/or your dependents a COBRA enrollment form. You and/or your dependents have 60 days after the event or date the COBRA enrollment form was sent, whichever is later, to elect COBRA coverage and return your enrollment form. You and/or your dependents have 45 days after making your election to pay back premiums. |
Your Human Resources office has 44 days after the event (or notification of your death) to send you and/or your dependents a COBRA enrollment form. You and/or your dependents have 60 days after the event or date the COBRA enrollment form was sent, whichever is later, to elect COBRA coverage and return your enrollment form. You and/or your dependents have 45 days after making your election to pay back premiums. |
|
| If you or your dependent becomes eligible for Social Security disability benefits within 60 days of the date your coverage ended, you or your dependent must notify your Human Resources office within 60 days of receiving notice from the Social Security Administration and before the end of the initial 18-month COBRA period. If you and/or your dependents miss any of these deadlines, you and/or your dependents forfeit your rights to continue coverage. | ||
After you notify your Human Resources office of an event or after an event not requiring notification, your Human Resources office will send an enrollment form within 44 days to the person(s) eligible for extended coverage. The enrollment form will include information about deadlines and costs of this coverage.
To continue coverage, you and/or your covered family members must pay the full premium plus an additional 2% to cover administrative costs. The COBRA coverage must begin the first of the month following the month in which you lost coverage.
If, in anticipation of a divorce, you drop your spouse’s coverage during Annual Enrollment or due to a change in status, under certain circumstances your spouse will be offered COBRA continuation coverage from the date of the divorce if you or your ex-spouse notifies your Human Resources office of the divorce. Coverage will not be available for the time between the date you first dropped your spouse’s coverage and the divorce date.
If you and covered family members elect extended coverage due to your termination of employment or reduction in hours, your covered family members may elect an additional extension period of up to 18 months (for an overall total of 36 months) if during the initial extension period:
- you die,
- you divorce, or
- you become entitled to Medicare.
If your child stops qualifying for coverage (for example, due to marriage or age) during the initial extension period, that child may extend coverage for an additional 18 months (for an overall total of 36 months).
To be eligible for the additional extended coverage, your covered family members must notify the A&M System within 60 days of the occurrence of one of these events.
When a person on 18 months of COBRA coverage becomes disabled within the first 60 days of COBRA coverage, that person and other covered family members may extend COBRA coverage for an additional 11 months. To do so, the disabled person or a family member must notify the appropriate institution or agency Human Resources office of the disabled person’s eligibility for Social Security disability benefits. This notification must be made within 60 days of the disabled person receiving the determination from the Social Security Administration and before the end of the initial 18-month COBRA period.
The cost of coverage will be approximately 50% higher during the final 11 months of COBRA coverage due to a Social Security-eligible disability if the disabled person alone or the disabled person and other family members elect to extend coverage during that period. The cost will remain 2% higher if the disabled person does not extend coverage but family members do.
Coverage stops before the end of the extension period if:
- the required premium is not paid,
- you or a family member becomes covered under another group health, dental and/or vision plan, unless that plan has a pre-existing condition provision that limits your benefits,
- you or a dependent becomes entitled to benefits under Medicare (if enrolled in a System health plan), or
- the System no longer offers health, dental and/or vision coverage to its employees.
Questions about any of this information? E-mail us and we'll forward your questions to the appropriate Human Resources office.
