Enrolling in COBRA Coverage
Your right to COBRA Coverage
The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), entitles you to elect continued coverage under the group health plan, if you will no longer have benefits with Benefit Options because of one of the following qualifying events:
- Termination of employment
- Reduction of work hours
- Loss of eligibility
- Death of covered employee
- Divorce or legal separation
- Covered employee’s entitlement to Medicare
COBRA coverage is also available to your spouse and dependent children, if they were covered on your plan the day of the qualifying event.
COBRA Enrollment Options
You can choose:
- To continue family or two-party coverage, if you had family or two-party coverage on the date of the qualifying event
- For one of more qualifying persons to individually elect single coverage
- For all qualifying persons to decline COBRA coverage entirely.
Duration of COBRA Coverage
You are eligible for COBRA coverage for 18, 29, or 36 months, depending on the nature of the qualifying event.
Your COBRA coverage may terminate early if:
- Health coverage is no longer offered to any active employees
- You do not make the required payments in a timely manner
- You, your spouse, or your dependent children become covered under another group health plan that does not effectively limit coverage for any pre-existing condition
- You, your spouse, or your dependent children become entitled to Medicare
- Coverage was extended due to disability and the individual is determined to no longer be disabled.
If you are Electing COBRA Coverage
You have 60 days from the date you received the notice to elect COBRA coverage. You should complete enrollment form A and return it to the Benefit Services Office postmarked no later than 60 days from the date you received the notice. Your COBRA coverage will begin at the full premium amount.
Declining COBRA Coverage
To decline COBRA coverage, return COBRA enrollment Form A with the “I decline COBRA coverage” option marked. COBRA
coverage will not be available to you once it is declined.
If you fail to return an enrollment form, your right to COBRA coverage will expire after 60 days from the date you received the notice.

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