Benefits Continuation: COBRA

Function:

Human Resources

Procedure

N/A

Contact:

Kathleen Caggiano-Siino

Guideline Recommendations

This document may be used as a reference by Campus Benefit Administrators for guidance on benefits continuation when an employee is covered by the Consolidated Omnibus Budget Reconciliation Act (COBRA) and for guidance on benefits continuation requirements for employees and their dependents.

An Employee's Right to Choose COBRA Coverage

COBRA is a federal law that requires the Research Foundation (RF) to offer its employees and their covered dependents the right to continue health, dental and vision care coverage. The right to choose continuation of coverage is available after an employee terminates employment, either voluntarily or involuntarily, or when the employee or dependent is no longer eligible for coverage because of certain qualifying events (e.g., reduction in hours of employment or a child reaching the limiting age).

Coverage After Termination

Terminated employees and their covered dependents are eligible to continue coverage as shown in the following table:

Who is Covered

Types of Benefits

Coverage Continuation

Employees who terminate either voluntarily or involuntarily and their covered dependents

Health, dental, vision care and healthcare FSA

Coverage may be continued under COBRA. See coverage sections below for more information.

Health insurance can also be continued on a direct-payment basis with the carrier. As soon as employment ends, the employee should contact Empire Blue Cross or his or her HMO.

When employee incurs COBRA qualifying event:

Campus administrators should enter COBRA qualifying event information into the PayFlex system.

Employees will be provided the following information from our COBRA Administrator after the qualifying event is entered by Campus administrator:

Maximum Coverage

If employment ends or work hours are reduced and the employee is no longer eligible for group insurance coverage, the employee and his or her covered dependents may continue coverage for a maximum of 18 months under Federal law. New York state law extends the COBRA period from 18 months to 36 months for medical coverage only.

Coverage for Dependents: Qualifying Events

Dependents of employees covered by the RF group insurance plans may choose to continue COBRA coverage for a maximum of 36 months, provided the coverage ended because of one of the following circumstances:

Adding Dependents to COBRA Coverage

A COBRA participant may add a dependent child to COBRA coverage either at birth or adoption and the child will have full COBRA rights.

Premium Payment

Employees and their covered dependents may choose COBRA to continue health, dental, vision care, and healthcare FSA coverage by paying to our COBRA Administrator the required monthly COBRA premium (employer and employee share) plus an administrative fee of 2 percent. The employee will have 45 days from the date he or she elected coverage in which to pay the premium.

Refer to COBRA Premiums for Continuation of Health Benefits for Regular Employees and Dependents for current premium information.

When COBRA Coverage Ends

COBRA coverage will terminate if any of the following situations occur:

Change History

Date

Summary of Change

January 3, 2019

Updated to include PayFlex as the new COBRA Administrator

May 25, 2016

Routine updates to links and minor clarifications to content

May 7, 2012

Updated links for new RF logo and COBRA mailing address

March 18, 2010

Clarified New York extension rules

November 1, 2010

Changed coverage continuation period from 18 months to 36 months; Removed Coverage Extension Period section; Removed paragraph on administrative fee if total disability under Premium Payment section.

April 3, 2006

Added Coverage After Termination section.

July 28, 2005

Updated to new format.

 

 

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