COBRA enables you or enrolled family members to continue medical, dental and/ or vision coverage in the event of a qualifying event that causes a loss of coverage. Examples of qualifying events include:

• Termination of employment (except for gross misconduct)
• Reduction in employment
• Divorce, legal separation, annulment, or termination of domestic partnership
• Death of employee
• Loss of dependent child status

The length of continuation varies, depending on the qualifying event.

• 18-month period for:
  • Voluntary or involuntary termination of employment (except for gross misconduct)
  • Reduction in hours (includes leave without pay or layoff)
• 36-month period for:
  • Divorce, legal separation, annulment, or termination of domestic partnership
  • Death of the employee
  • Loss of dependent child status

COBRA applies to the Health Care Reimbursement Account (HCRA) for employees leaving UC employment. SHPS sends a Qualified Event Notice explaining the procedure.

Premiums for COBRA (PDF) change annually. Premiums are billed monthly.

Notification of COBRA eligibility depends on the qualifying event:

• Your separation: After your department enters a separation date in the Payroll Personal System (PPS), or changes the Benefits Eligibility Indicator Code (BELI), Benefits will mail a COBRA packet to the address in your record.
• Divorce, legal separation, or termination of domestic partnership: As the employee, you need to complete a Notice to UC of a COBRA Qualifying Event (PDF) and send it to Benefits, Mail Code 0926. They will mail the COBRA packet to you.
• Over-age dependent: UC Benefits sends a letter and automatically de-enrolls an over-age dependent from medical, dental, and vision coverage. If you would like COBRA coverage, complete the Notice to UC of a COBRA Qualifying Event (PDF), and send it to Benefits, Mail Code 0926. They will mail the COBRA packet to you.

To enroll in medical, dental, and/ or vision via COBRA, complete the enrollment application in your COBRA packet. The packet will also include Mailing Addresses and Premium Information (PDF). Mail the enrollment form with the appropriate premium payment(s) to the health plan for processing. Be sure to keep a copy for your records. The Benefits office does not receive copies of forms.

For more information, see At Your Service information on COBRA.

Need an expert? Contact your Benefits representative.