COBRA Continuation Coverage- See also Leaving and Changes to Your Benefits on the HR section of AccessTufts
The right to COBRA continuation of coverage was created by a federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). COBRA continuation of coverage can become available to you when you would otherwise lose your group health coverage. It can also become available to other members of your family who are covered under one or more of the benefit plans when they would otherwise lose their group health coverage. COBRA applies to Health, Dental, Vision, and Flexible Spending Account benefits.
COBRA continuation of coverage is a continuation of coverage under the existing benefit plan when coverage would otherwise end because of a life event known as a “qualifying event.” Specific qualifying events are listed later in this section. After a qualifying event, COBRA continuation of coverage must be offered to each person who is a “qualified beneficiary.” You, your Spouse, and your dependent children could become qualified beneficiaries if coverage under a benefit plan is lost because of the qualifying event. Under the benefit plans, qualified beneficiaries who elect COBRA continuation of coverage must pay to continue coverage under COBRA.
Note that the Health/Dental/Vision plan election can only be changed at COBRA annual Open Enrollment, not at time of initial COBRA enrollment. Flexible Spending Account elections can also not be modified at time of initial COBRA enrollment, but only at annual COBRA Open Enrollment.
If you are an employee, you will become a qualified beneficiary if you lose your coverage under a benefit plan because either one of the following qualifying events happens:
- your hours of employment are reduced; or
- your employment ends for any reason other than your gross misconduct.
If you are the Spouse of an employee, you will become a qualified beneficiary if you lose your coverage under the benefit plan because any of the following qualifying events happens:
- your Spouse dies;
- your Spouse’s hours of employment are reduced;
- your Spouse’s employment ends for any reason other than his or her gross misconduct; or
- you become divorced from your Spouse.
Your dependent children will become qualified beneficiaries if they lose coverage under the plan because any of the following qualifying events happens:
Questions concerning your benefit plans or your COBRA continuation of coverage rights should be addressed to the contact or contacts identified below. For more information about your rights under ERISA, including COBRA, the Health Insurance Portability and Accountability Act (HIPAA), and other laws affecting group health plans, you may also contact the nearest Regional or District Office of the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) in your area or visit the EBSA website at www.dol.gov/ebsa. Additional information about COBRA continuation coverage can be found in the benefits Summary Plan Description for Tufts University.
- the parent-employee dies;
- the parent-employee’s hours of employment are reduced;
- the parent-employee’s employment ends for any reason other than his or her gross misconduct;
- the parents become divorced; or
- the child stops being eligible for coverage under the plan as a “dependent child.”
Vendor Contact Information:
EBPA If you do not receive this COBRA notice within three weeks following your last day worked, please contact EBPA at (888) 678-3457. EBPA37 Industrial Drive, Suite EExeter, NH 038331-888-232-3203FAQ:
Q. I’m leaving the University. What happens to my benefits?
Generally, your University benefits end on your last day of work. This happens automatically, and you don’t need to do anything (unless you would like to enroll in COBRA-see next question). If you have specific questions, please contact Tufts Support Services at (617) 627-7000. Otherwise, you will receive a letter within two weeks of your last pay date that explains this process in further detail.
Q: I have health insurance through Tufts University and am leaving. However, I need to keep my health insurance for a while. Can I do that?
Yes, you can retain your existing health insurance coverage through COBRA up to 18 months after leaving Tufts University. You will receive information about COBRA from EBPA, our third-party administrator, within 2 weeks of your last pay date. Once notified, you will have 60 days to elect COBRA and if elected, coverage will be retroactive to your last day worked.
Q: Can I change to a different health insurance when I elect COBRA?
No, you need to remain on your existing coverage and can only elect a different plan at COBRA Open Enrollment.
Q: Will there be a gap in coverage if I have to wait up to two weeks?
No, there won’t be a gap in coverage. Once payment has been received, COBRA is retroactively effective to your termination date. If you need to seek medical services in the meantime, let your doctor’s billing office know that you’re enrolling in COBRA through your former employer and ask if they can bill in a week or two.