COBRA

COBRA is a continuation of coverage in which your ADOA benefits will start the day after your active benefits end. To continue your coverage, you must elect COBRA. Your coverage does not automatically roll over.

PROCESS OVERVIEW

  1. Packet: Your COBRA packet and enrollment form are mailed to you 14 business days after your agency/university enters your termination information into our system. You cannot receive a form before this time.
  2. Enrollment: You have 60 days to enroll after you receive the packet.
  3. Payment: You have an additional 45 days to pay AFTER you send in the enrollment form. (Recommended: Send in payment with your enrollment form since coverage does not begin until payment is received.)
  4. Coverage:  Does not begin until the first payment is received. 
  5. Monthly Billing: After the first payment is received at ADOA, you will receive a monthly billing statement in the mail. You may begin making payments online if desired. See "COBRA Online Bill Pay" below.

  • You cannot make your FIRST COBRA PAYMENT online since your account is not set up until you submit your enrollment form and first payment via check or money order.
    • Mail your enrollment form with payment to ADOA-HITF, 100 N. 15th Ave., Suite 302, Phoenix, AZ 85007. Make the check/money order payable to: ADOA-HITF.
  • Use this link only AFTER you have made your first payment and received a monthly billing statement in the mail,  so you will have the information needed to set up an account.
    • This includes the biller account number and the online enrollment code printed on your billing statement.

COBRA Online Bill Pay

  • The complete COBRA packet will be mailed to you within 14 days of your agency/university entering your termination into our system.
  • If you do not receive a packet, contact ADOA - Benefits Services Division at 602-542-5008, 1-800-304-3687 or [email protected].  

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:

  • End of employment
  • Reduction in the hours of employment
  • Death of the employee under whom coverage was received
  • Divorce or legal separation
  • Losing dependent child status
  • Your spouse and dependent children are eligible for COBRA if they were covered on your plan on the day of the qualifying event. See "Enrollment Options" below. 

You can choose:

  1. To continue family or two-party coverage (for example, you and your spouse), if you had family or two-party coverage on the qualifying event date. See "Your Right to COBRA Coverage" above.
  2. For one or more qualifying persons to individually elect single coverage
  3. For all qualifying persons to decline COBRA coverage entirely

COVERAGE AVAILABLE

COBRA coverage applies to medical, dental, and vision coverage only. For rates, please refer to the rate chart below.
For information on life insurance, FSAs, and HSAs, please see the "Additional Information" tab below

COBRA RATES

New Retirees

  • ADOA is required by federal law to send a COBRA notice to new retirees, terminating employees, and those who have lost coverage due to certain qualifying life events.
  • Please contact ADOA if you wish to enroll in coverage as a new retiree. If you have already enrolled in ADOA or ASRS retiree coverage, you do not need to enroll in COBRA.
  • ADOA Benefit Options Member Services at 602-542-5008 or 1-800-304-3687.

Medicare

  • If you are over 65 and were actively employed, upon leaving State service, you are eligible to elect COBRA coverage.
  • If you are on Medicare when you enroll in COBRA, you may continue coverage.
  • If you turn 65 while you are on COBRA coverage, your COBRA coverage will be terminated automatically at the end of the month you turn 65 and you then must enroll in Medicare. The same rules apply for your covered dependents.

Life Insurance Policy

  • You may be eligible to continue life insurance coverage through portability or conversion. For more information, contact Securian: 833-745-5517.
  • Former Elected Officials – If you have five years of credited service as an elected official, you may continue your Basic Life/AD&D and Dependent Life Insurance. When calling Securian, please identify yourself as a "former elected official" to ensure you are speaking to the appropriate department.

Flexible Spending Accounts | FSA

  • For information regarding continuing your Healthcare or Dependent Flexible Spending account, contact TASC Member Services: 833-433-4301, or tasconline.com.

Health Savings Accounts | HSA

  • Your account will be converted to an individual account. For more information, contact Optum Financial: 866-610-4839 or optumbank.com/arizona.

You are eligible for COBRA coverage for 18, 29, or 36 months, depending on the nature of the qualifying event. Your packet will give you full information.

Your COBRA coverage may terminate early if:

  • Any required premium is not paid in full and on time
  • If, after electing COBRA continuation coverage, a qualified beneficiary becomes entitled to Medicare benefits (under Part A, Part B, or both)
  • The employer ceases to provide group health coverage for any of its employees

  • 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 on the COBRA notification.

  • Your child will be eligible for COBRA coverage when they turn age 26 and are no longer eligible to be covered under a parent's plan. 
  • A COBRA packet will be mailed to them.
  • See the Age 26 process document for more information.